放射诊断科孙柏龄(1).pptVIP

Clinical brain tumor of MRI 放射診斷科孫柏齡 2007.04.20 Case 1 Clinical History: 17-year-old female with a clinical suspicion of cerebellar mass. Your diagnosis is Radiologic Findings: A T1W image (Fig. 1) shows a hypointense, approximately 7cm x 4cm mass in the right cerebellar hemisphere, with a moderate amount of mass effect on the 4th ventricle and cerebellum. The mass is hyperintense on the T2W image (Fig. 3). The cystic portion of the mass has signal intensity similar to CSF on the T1W images and T2W images, but is hyperintense to CSF on the proton density weighted image (Fig. 2) due to increased protein content. Following Gadolinium administration, T1W images (Fig. 4-6) show intense homogeneous enhancement of a mural nodule in the superior aspect of the mass. Although septations within the mass show faint enhancement, the cystic portion of the mass does not show enhancement. Diagnosis: Juvenile pilocytic astrocytoma. Discussion: Cerebellar juvenile pilocytic astrocytomas are the most common infratentorial neoplasm in the pediatric age group. Although they commonly form well-defined lobular masses which contain cysts and a vascular mural nodule, they may occasionally present a solid mass without a cystic component and may simulate other pediatric posterior fossa masses. They have an increased incidence in type I neurofibromatosis. They have an excellent prognosis following complete resection. The differential diagnosis includes medulloblastoma and ependymoma in a child. Case 2 Clinical History: 3-year-old presents with headache and ataxia. Your Diagnosis is? Diagnosis: Ependymoma. Findings: Axial CT image demonstrates a right cerebellar and fourth ventricle mass which is somewhat higher in attenuation than the remaining brain parenchyma. In addition, there is marked dilatation of the temporal horns indicating hydrocephalus. Axial T1 and T2 weighted images as well as a sagittal image following the intravenous administration of contrast de