Intracerebral metastases MRI

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

Overview

On MRI, brain metastases are typically found in the watershed areas of the brain (areas where blood vessels narrow and act as a trap for clumps of tumor cells).^[1]


MRI component	Findings

T1	Typically iso- to hypointense If hemorrhagic, may have intrinsic high signal Non-hemorrhagic melanoma metastases can also have intrinsic high signal due to the paramagnetic properties of melanin
T1 with contrast	Enhancement pattern can be uniform, punctate, or ring-enhancing, but it is usually intense Delayed sequences may show additional lesions, therefore contrast-enhanced MRI is the current standard for small metastases detection
T2	Typically hyperintense Hemorrhage may alter this (hypointense)
FLAIR	Typically hyperintense with hyperintense peri-tumoral edema
Diffusion weighted imaging (DWI)	Edema is out of proportion with tumor size and appears dark on trace-weighted DWI

_{Brain metastasis in the right cerebral hemisphere from lung cancer shown on T1-weighted magnetic resonance imaging with intravenous contrast.^[2]}
_{Coronal T1 C+ head within the parieto-occipital region on the left demonstrates a very rounded brightly peripherally enhancing mass located near the grey-white junction, surrounded by a moderate amount of vasogenic edema. The central region of lower signal intensity does not enhance nor does it restrict. Features are consistent with the patient's known metastatic disease with bull's eye sign.^[3]}

↑ Khuntia, Deepak (2015). "Contemporary Review of the Management of Brain Metastasis with Radiation". Advances in Neuroscience. 2015: 1–13. doi:10.1155/2015/372856. ISSN 2356-6787.
↑ MRI image of brain metastasis. Wikipedia 2015. https://en.wikipedia.org/wiki/Brain_metastasis. Accessed on November 9, 2015
↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC