Craniopharyngioma diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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.
Diagnostic Study of Choice
- Craniopharyngiomas have the most heterogeneous radiologic appearance of any suprasellar neoplasm.
- Craniopharyngioma can offer a challenge in arriving at the correct diagnosis. In particular, the radiologic characteristics of Rathke cleft cyst can overlap that of adamantinomatous craniopharyngioma.
Study of choice
- Pre and post contrast enhanced MR imaging with attention to the sellar region is the modality of choice when evaluating craniopharyngioma.
- The superior contrast resolution and tissue characterization, as well as the multiplanar capability of this technique, make it the radiologist’s most indispensable tool.
- High-resolution, thin-section, T1-weighted imaging of the sellar region in the sagittal and coronal planes is mandatory, and should be obtained both pre- and post-contrast administration.
- Dynamic enhanced imaging of the sellar region can be performed if diagnostic considerations include pituitary microadenoma or the rare parasellar cavernous hemangioma.
- CT is also sensitive in the detection of fat density, which is valuable in the suprasellar region when the differential include Rathke cleft cyst.