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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-CystHighonT1LowonT2
2、DiffusionweightedimagingPerfusionImagingEnhancementDifferentialdiagnosis forspecificanatomicareaSkullbaseSella/suprasellarCerebello-pontineanglePinealregionIntraventricular4thventricleTumorMimicsSchwannomalocatedinthecerebellopontineangle(CPA)withtypicalsignsofanextr
3、aaxialtumorMeningiomawithabroadduralbaseandaduraltail，hyperostosisintheadjacentbone，enhanceshomogeneously，noblood-brain-barrierMelanomametastasiswithgraymatterontheanteromedialsideofthelesion(redarrow)，intra-axial.Ependymomawithextensiontothecerebellopontineangle(blu
4、earrow)andintotheforamenmagnum(redarrow)ortothecisternamagnaToassesstheextentofatumor. Anextra-axialtumorintheregionoftheleftcavernoussinuswithhomogeneousenhancementandabroadduraltail. Thisistypicalforameningioma.Actualextentofthistumorisgreaterthanexpected. Thetumor
5、issituatedinthepterygopalatinefossaandextendsintotheorbit. Italsospreadsanteriorlyintothemiddlecranialfossa.Considerationfortheeffectonthesurroundingstructures.Primarybraintumorsarederivedfrombraincellsandoftenhavelessmasseffectfortheirsizethanyouwouldexpect,duetothe
6、irinfiltrativegrowth.Thereisnoenhancementsothiswouldprobablybealow-gradeastrocytomaTheabilityoftumorstocrossthemidlineGlioblastomamultiforme(GBM)frequentlycrossesthemidlinebyinfiltratingthewhitemattertractsofthecorpuscallosum.RadiationnecrosiscanlooklikerecurrentGBMa
7、ndcansometimescrossthemidline.Meningiomaisanextra-axialtumorandcanspreadalongthemeningestothecontralateralside.Lymphomaisusuallylocatednearthemidline.Epidermoidcystscancrossthemidlineviathesubarachnoidspace.MScanalsopresentasamasslesioninthecorpuscallosum.Left:Metast
8、asesRight:MultiplemeningiomasandaschwannomainapatientwithNeurofibromatosisIIMultifocaldisease: Metastaticdisease lymphomasMulticent
