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1、BrainTumor-SystematicApproachbyRobinSmithuisandWalterMontanera河南省人民醫(yī)院放射科 高明譯講IntroductionIncidenceofCNStumorsAgedistributionTumorspreadIntra-versusExtraaxialMidlinecrossingMultifocaldiseaseCorticalbasedtumorsCTandMRCharacteristicsFat-Calcification-CystHighonT1LowonT2Dif
2、fusionweightedimagingPerfusionImagingEnhancementDifferentialdiagnosis forspecificanatomicareaSkullbaseSella/suprasellarCerebello-pontineanglePinealregionIntraventricular4thventricleTumorMimicsSchwannomalocatedinthecerebellopontineangle(CPA)withtypicalsignsofanextraaxial
3、tumorMeningiomawithabroadduralbaseandaduraltail，hyperostosisintheadjacentbone，enhanceshomogeneously，noblood-brain-barrierMelanomametastasiswithgraymatterontheanteromedialsideofthelesion(redarrow)，intra-axial.Ependymomawithextensiontothecerebellopontineangle(bluearrow)an
4、dintotheforamenmagnum(redarrow)ortothecisternamagnaToassesstheextentofatumor. Anextra-axialtumorintheregionoftheleftcavernoussinuswithhomogeneousenhancementandabroadduraltail. Thisistypicalforameningioma.Actualextentofthistumorisgreaterthanexpected. Thetumorissituatedin
5、thepterygopalatinefossaandextendsintotheorbit. Italsospreadsanteriorlyintothemiddlecranialfossa.Considerationfortheeffectonthesurroundingstructures.Primarybraintumorsarederivedfrombraincellsandoftenhavelessmasseffectfortheirsizethanyouwouldexpect,duetotheirinfiltrativeg
6、rowth.Thereisnoenhancementsothiswouldprobablybealow-gradeastrocytomaTheabilityoftumorstocrossthemidlineGlioblastomamultiforme(GBM)frequentlycrossesthemidlinebyinfiltratingthewhitemattertractsofthecorpuscallosum.RadiationnecrosiscanlooklikerecurrentGBMandcansometimescros
7、sthemidline.Meningiomaisanextra-axialtumorandcanspreadalongthemeningestothecontralateralside.Lymphomaisusuallylocatednearthemidline.Epidermoidcystscancrossthemidlineviathesubarachnoidspace.MScanalsopresentasamasslesioninthecorpuscallosum.Left:MetastasesRight:Multiplemen
8、ingiomasandaschwannomainapatientwithNeurofibromatosisIIMultifocaldisease: Metastaticdisease lymphomasMulticent
