Ependymoma MRI

Ependymoma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Epidemiology and Demographics
Risk Factors
Differentiating Ependymoma from other Diseases
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Staging
Laboratory Findings
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Ependymoma MRI On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Ependymoma MRI All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Ependymoma MRI
CDC on Ependymoma MRI
Ependymoma MRI in the news
Blogs on Ependymoma MRI
Directions to Hospitals Treating Ependymoma
Risk calculators and risk factors for Ependymoma MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

Brain MRI may be diagnostic of ependymoma. Finding on brain MRI suggestive of ependymoma include large mixed cystic/solid lesion with haemorrhage and fluid which may indicate areas of necrosis.

MRI

• T1

• Solid portions of ependymoma typically are isointense to hypointense relative to white matter 7

• T2

• Hyperintense to white matter
• More reliable in differentiating tumor margins than non-contrast T1-weighted images (but less reliable than contrast enhanced T1)

• T2* (e.g. SWI)

• Foci of blooming from haemorrhage or calcification

• T1 C+ (Gd)

• Enhancement present but heterogeneous
• Enhancement with gadolinium is useful in differentiating tumor from adjacent vasogenic edema and normal brain parenchyma

• DWI/ADC

• Restricted diffusion may be seen in solid components especially in anaplastic tumour
• Diffusion should be interpreted with caution in masses with significant haemorrhage or calcification

• MRS

• Choline peak elevation according to the cellularity of tumor
• N-Acetylaspartate peak reduction
• Elevated choline/creatinine ratio
• Lipid and lactate rise when degeneration occurs

• 
  T1
• 
  T2
• 
  FLAIR
• 
  T1
• 
  T1 C+
• 
  DWI

^{Note:There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.}