Craniopharyngioma MRI
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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. 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.
MRI
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The MRI findings depend on the type of craniopharyngioma.[1]
Adamantinomatous
- Adamantinomatous type is the most common form (90%.
- Solid components are present, but usually form a relatively minor component of the mass.
- The calcification is very common.
- Tumor have a predilection to be large, extending superiorly into the third ventricle, and encasing vessels.[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.
- Calcification is uncommon or even rare in the papillary subtype.
- Papillary tumors tend to displace adjacent structures.[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.