Craniopharyngioma MRI: Difference between revisions
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The MRI findings depend on the type of craniopharyngioma.<ref>MRI findings of Craniopharyngioma. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/craniopharyngioma</ref> | The MRI findings depend on the type of craniopharyngioma.<ref>MRI findings of Craniopharyngioma. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/craniopharyngioma</ref> | ||
===Adamantinomatous=== | ===Adamantinomatous=== | ||
Adamantinomatous type is the most common form (90%), and typically have a lobulated contour as a result of usually multiple cystic lesions. Solid components are present, but usually form a relatively minor component of the mass, and enhance vividly on MRI scans. The calcification is very common (90%). These tumor have a predilection to be large, extending superiorly into the [[third ventricle]], and encasing vessels, and even being adherent to adjacent structures. The findings on MRI are: | Adamantinomatous type is the most common form (90%), and typically have a lobulated contour as a result of usually multiple cystic lesions. Solid components are present, but usually form a relatively minor component of the mass, and enhance vividly on MRI scans. The calcification is very common (90%). These tumor have a predilection to be large, extending superiorly into the [[third ventricle]], and encasing vessels, and even being adherent to adjacent structures. The findings on MRI are:<ref name="pmid13883661">{{cite journal |vauthors=DATI T |title=[Radiology of craniopharyngiomas with special reference to pneumoencephalography. II] |language=Italian |journal=Rass Fisiopatol Clin Ter |volume=33 |issue= |pages=955–67 |date=October 1961 |pmid=13883661 |doi= |url=}}</ref> | ||
*'''Cysts''' | *'''Cysts''' | ||
**Variable but 80% are mostly or partly T2 hyperintense | **Variable but 80% are mostly or partly T2 hyperintense | ||
Line 29: | Line 29: | ||
*Susceptible sequences may better demonstrate calcification | *Susceptible sequences may better demonstrate calcification | ||
'''MR angiography''': It may demonstrate displacement of the A1 segment of the [[anterior cerebral artery]] (ACA). | '''MR angiography''': It may demonstrate displacement of the A1 segment of the [[anterior cerebral artery]] (ACA).<ref name="pmid29877209">{{cite journal |vauthors=Nishioka H, Nagata Y, Fukuhara N, Yamaguchi-Okada M, Yamada S |title=Endoscopic Endonasal Surgery for Subdiaphragmatic Type Craniopharyngiomas |journal=Neurol. Med. Chir. (Tokyo) |volume=58 |issue=6 |pages=260–265 |date=June 2018 |pmid=29877209 |pmc=6002681 |doi=10.2176/nmc.oa.2018-0028 |url=}}</ref> | ||
'''MR spectroscopy''': [[Cyst]] contents may show a broad lipid spectrum, with an otherwise flat baseline. | '''MR spectroscopy''': [[Cyst]] contents may show a broad lipid spectrum, with an otherwise flat baseline. | ||
===Papillary=== | ===Papillary=== | ||
Papillary craniopharyngioma tend to be more ''spherical'' in outline and usually lack the prominent cystic component; most are either ''solid'' or contain a few smaller cysts. Calcification is uncommon or even rare in the papillary subtype. These tumors tend to displace adjacent structures. The findings on MRI are: | Papillary craniopharyngioma tend to be more ''spherical'' in outline and usually lack the prominent cystic component; most are either ''solid'' or contain a few smaller cysts. Calcification is uncommon or even rare in the papillary subtype. These tumors tend to displace adjacent structures. The findings on MRI are:<ref name="pmid17825241">{{cite journal |vauthors=Van Effenterre R, Boch AL |title=[Craniopharyngiomas] |language=French |journal=Ann. Endocrinol. (Paris) |volume=68 |issue=6 |pages=412–21 |date=December 2007 |pmid=17825241 |doi=10.1016/j.ando.2007.08.001 |url=}}</ref> | ||
*'''Cysts''' | *'''Cysts''' | ||
**When present they are variable in signal | **When present they are variable in signal.<ref name="pmid14095868">{{cite journal |vauthors=MATSON DD |title=CRANIOPHARYNGIOMA |journal=Clin Neurosurg |volume=10 |issue= |pages=116–29 |date=1964 |pmid=14095868 |doi= |url=}}</ref> <ref name="pmid27846921">{{cite journal |vauthors=Burrell S, Hebb AL, Imran SA, Mishra A, Mawko G, Clarke DB |title=Visualization of 90Yttrium Colloid Within a Cystic Craniopharyngioma Using PET/CT/MRI Fusion |journal=Can J Neurol Sci |volume=44 |issue=2 |pages=192–193 |date=March 2017 |pmid=27846921 |doi=10.1017/cjn.2016.410 |url=}}</ref> | ||
**85% T1 hypointense | **85% T1 hypointense | ||
*'''Solid component''' | *'''Solid component''' |
Revision as of 15:30, 14 February 2019
Craniopharyngioma Microchapters |
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Craniopharyngioma MRI On the Web |
American Roentgen Ray Society Images of Craniopharyngioma MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]
Overview
The diagnostic evaluation of craniopharyngioma includes high-definition brain imaging. Brain MRI with and without contrast is the gold standard. Computed tomography (CT) scan is optional and may show some calcifications that can be seen in these tumors. However CT is not specific enough as a standalone diagnostic test. vascular imaging studies such as MR angiography (MRA) or CTA, is decided on a case-by-case basis typically for surgical planning or if a possible vascular malformation is spuspected.
MRI
The MRI findings depend on the type of craniopharyngioma.[1]
Adamantinomatous
Adamantinomatous type is the most common form (90%), and typically have a lobulated contour as a result of usually multiple cystic lesions. Solid components are present, but usually form a relatively minor component of the mass, and enhance vividly on MRI scans. The calcification is very common (90%). These tumor have a predilection to be large, extending superiorly into the third ventricle, and encasing vessels, and even being adherent to adjacent structures. The findings on MRI are:[2]
- Cysts
- Variable but 80% are mostly or partly T2 hyperintense
- T1: iso- to hyperintense to brain (due to high protein content machinery oil cysts)
- Solid component
- T1 C+ (Gd): vivid enhancement
- T2: variable or mixed
- Calcification
- Difficult to appreciate on conventional imaging
- Susceptible sequences may better demonstrate calcification
MR angiography: It may demonstrate displacement of the A1 segment of the anterior cerebral artery (ACA).[3]
MR spectroscopy: Cyst contents may show a broad lipid spectrum, with an otherwise flat baseline.
Papillary
Papillary craniopharyngioma tend to be more spherical in outline and usually lack the prominent cystic component; most are either solid or contain a few smaller cysts. Calcification is uncommon or even rare in the papillary subtype. These tumors tend to displace adjacent structures. The findings on MRI are:[4]
- Cysts
- Solid component
- T1: iso- to lightly hypointense to brain
- T1 C+: vivid enhancement
- T2: variable/mixed
References
- ↑ MRI findings of Craniopharyngioma. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/craniopharyngioma
- ↑ DATI T (October 1961). "[Radiology of craniopharyngiomas with special reference to pneumoencephalography. II]". Rass Fisiopatol Clin Ter (in Italian). 33: 955–67. PMID 13883661.
- ↑ Nishioka H, Nagata Y, Fukuhara N, Yamaguchi-Okada M, Yamada S (June 2018). "Endoscopic Endonasal Surgery for Subdiaphragmatic Type Craniopharyngiomas". Neurol. Med. Chir. (Tokyo). 58 (6): 260–265. doi:10.2176/nmc.oa.2018-0028. PMC 6002681. PMID 29877209.
- ↑ Van Effenterre R, Boch AL (December 2007). "[Craniopharyngiomas]". Ann. Endocrinol. (Paris) (in French). 68 (6): 412–21. doi:10.1016/j.ando.2007.08.001. PMID 17825241.
- ↑ MATSON DD (1964). "CRANIOPHARYNGIOMA". Clin Neurosurg. 10: 116–29. PMID 14095868.
- ↑ Burrell S, Hebb AL, Imran SA, Mishra A, Mawko G, Clarke DB (March 2017). "Visualization of 90Yttrium Colloid Within a Cystic Craniopharyngioma Using PET/CT/MRI Fusion". Can J Neurol Sci. 44 (2): 192–193. doi:10.1017/cjn.2016.410. PMID 27846921.