Features of various posterior cranial fossa tumors on Magnetic Resonance Imaging and their correlation with histopathological diagnosis
DOI:
https://doi.org/10.47672/ajhmn.819Abstract
Purpose: To evaluate the features of various posterior cranial fossa tumors on Magnetic Resonance Imaging and correlate the MR diagnosis with histopathological diagnosis.
Methodology: The MRI evaluation of patients clinically presenting with nonspecific symptoms of raised intracranial pressure was done. The MR imaging protocol included: T1W, T2W, FLAIR and post Gd T1W FS. The MRI diagnosis was correlated with histopathological diagnosis. Descriptive statistical analysis was carried out in the present study.
Findings: Histopathological confirmation was obtained in 38 of 46 cases. The eight patients in whom histopathologic examination was not obtained included four cases of metastasis and four cases of pontine glioma. In metastases, the primary was known. In pontine gliomas the characteristic MR findings were present and due to increased frequency of complications the risky biopsy in this area was not performed.
Unique contribution to theory, practice and policy (recommendations): The MR imaging diagnosis was found to correlate with the histopathologic diagnosis in most instances. MR imaging was found to be highly sensitive in evaluating tumor related complications. MRI showed the full extent of the tumor and involvement of the surrounding tissues, thus helping in the management of tumors. Hence it is recommended to perform MRI in cases of increased intracranial hypertension to make early and accurate diagnosis possible and hence improve the patient management.
Downloads
References
Andrea Poretti, Avner Meoded, Thierry A.G.M. Huisman. Neuroimaging of Pediatric Posterior Fossa Tumors. J. Magn. Reson. Imaging. 2012;35:32-47.
Bronstein K.S. Epidemiology and classification of brain tumours. Crit. Care Nurs Clin North Amer. 1995;7:79-89.
Rickert CH, Probst-cousin S, Gullotta F. Primary intracranial neoplasm of infancy and early childhood. Childs Nerv Syst, 1997;13, 507-13.
Friedman HS, Oakes WJ, Bigner SH et al: Medulloblastoma. Tumor biological and clinical perspectives. J Neurooncol 1991;11:1-15.
Cohen M.E., and Dufner, P.K. Tumours of the brain and spinal cord including leukemic infiltrates. In SwaimanK Fed, Pediatric Neurology Principles and Practice. St. Louis Mosby. 1991;945-950.
Brown MT, Friedman HS, Oakes WJ et al: Chemotherapy for pilocytic astrocytomas. Cancer 1993;71:3165-3172.
Bronstein K.S. Epidemiology and classification of brain tumours. Crit. Care Nurs. Clin. North Amer. 1995;7:79-89.
Pollack IF. Pediatric brain tumours. Semin Surg Oncol, 1999;16:73-90.
Minimanoff RO, Dosoret Z DE, Lingood RM et al: Meningioma. Analysis of recurrence and progression following neurosurgical resection. J neurosur 1965;62:18-24.
Segall H D, Destian S, Nelson M D et al. (1990) CT and MR imaging in malignant gliomas. In: Apuzzo M L J (ed.) Malignant Cerebral Glioma. Park Ridge, IL: American Association of Neurological Surgeons; pp 63-78.
Osborn A G (1994) Diagnostic Radiology. St. Louis: Mosby. 234-235
Hustinx R & Alavi A (1999) SPECT and PET imaging of brain tumors. Neuroimaging Clinics of North America 9:751-766
Lee BCP, Kneeland JB, Deck MDF, et al. Posterior fossa lesions: magnetic resonance imaging. Radiology 1984;153 :137-143
Lee BCP, Kneeland JB, Deck MDF, et al. Posterior fossa lesions: magnetic resonance imaging. Radiology 1984;153 :137-143
Lee BCP, Kneeland JB, Walker RW et al. MR imaging of brainstem tumours. AJNR Am J Neuroradiology 1985; 6; 159-163.
George AE, Russel EJ, Kricheff II. White matter buckling: CT sign of extra axial intracranial mass. AJNR Am J Neuroradiol 1980;1:425-430
Barkovich AJ: Pediatric brain tumors, Sem US, CT, MR 1992;13:412-448
Lizak PF, Woodruff WW: Posterior fossa neoplasms: multiplanar imaging, Semin US, CT, MR 1992;13:182-206
Nemoto Y, Inoue Y, Fukuda T et al: Displacement of the quadrigeminal plate in tumors of the fourth ventricle: MR appearance, J Comp Asst Tomogr 1989;13:769-772
Lavaroni A, Leonard M: Neuroradiological diagnostics of brain tumors in adults, Riv di Neuroradiol 1993;(suppl 2):41-54
Bilaniuk LT. Adult infratentorial tumors. Semin Roentgenol. 1990 Apr; 25(2):155-73.
Raphael Guzman, Alain Barth, Karl-Olof Lövblad. Use of diffusion-weighted magnetic resonance imaging in differentiating purulent brain processes from cystic brain tumors. J Neurosurg 2002;97:1101-1107.
Kinuko Kono, Yuichi Inoue, Keiko Nakayama, Miyuki Shakudo, Michiharu Morino, Kenji Ohata, Kenichi Wakasa, Ryusaku Yamada. The Role of Diffusion-weighted Imaging in Patients with Brain Tumors. AJNR Am J Neuroradiol. June/July 2001;22:1081-1088
Kim M. Cecil, Blaise V. Jones. Magnetic Resonance Spectroscopy of the Pediatric Brain. Topics in Magnetic Resonance Imaging. 2001;12(6):435-452
Rehman A.U., Lodhi S., Murad S. Morphological Pattern of Posterior Cranial, Fossa Tumors. ANNALS. APR. - JUN. 2009;15(2):57-59
P.K. Wanyoike. Posterior cranial fossa tumours in children at kenyatta national hospital, nairobi. East African Medical Journal. May 2004;81(5):258-260
Chang T, Teng MM, Lirng JF Posterior cranial fossa tumours in childhood. Neuroradiology. 1993;35(4):274-8.
Sarrazin J, Haclie O, Cordoliani Y. Cerebellopontine angle tumors in adults. J Radiol. 2000 Jun;81(6 Suppl):675-90.
Curnes JT. MR imaging of peripheral intracranial neoplasms: extraaxial vs intraaxial masses. J Comput Assist Tomogr.1987 Nov-Dec;11(6):932-7.
Mulkens TH, Parizel PM, De Schepper AM, van de Heyning PH, Forton GE, Martin JJ, Delaporte C. MRI of acoustic schwannoma: a retrospective study of 89 tumours.Rofo.1993Apr;158(4):362-7.
Izycka-Swieszewska E, Szurowska E, Kloc W, Rzepko R, Dubaniewicz-Wybieralska M, Skorek A, DrozyÃ…"žska E, Stempniewicz M. Cerebellopontine angle tumours:radiologic-pathologic correlation and diagnostic difficulties. Folia Neuropathol. 2006;44(4):274-81.
M Wakoh, H Yonezu, T Otonari, T Sano, K Matsuzaka, T Inoue and N Wada. Two cases of schwannoma with marked cystic changes. Dentomaxillofacial Radiology. 2005;34:44-50
Maiuri F, Iaconetta G de Divitiis O, et al. Intracranial Meningioma: correlations between MR imaging and histology. Eur J Radiol. July 1999; 31(1):69-75.
Scott W. Atlas. Magnetic resonance imaging of the Brain and Spine, 3rd ed. Baltimore: Williams & Wilkins, 2002:701.
Takeguchi T, Miki H, Shimizu T, Kikuchi K, Mochizuki T, Ohue S, Ohnishi T. The dural tail of intracranial meningiomas on fluid-attenuated inversion-recovery images. Neuroradiology. 2004 Feb; 46(2):130-5.
Carlos Majos, Gracia Cucurella, Carlos Aguilera et al Intraventricular Meningioma and MR spectroscopic Findings in two cases. AJNR Am J Neuroradiol 1999;882-885.
Bonneville F, Savatovsky J, Chiras J.Imaging of cerebellopontine angle lesions: an update. Part 1: enhancing extra-axial lesions. EurRadiol. 2007 Oct;17(10):2472-82.
Dutt SN, Mirza S, Chavda SV, Irving RM. Radiologic differentiation of intracranial epidermoids from arachnoid cysts. Otol Neurotol. 2002 Jan;23(1):84-92.
Wasenko JJ, Rosenbloom SA, Estes M, Lanzieri CF, Duchesneau PM. Magnetic resonance of intracranial epidermoids. Eur J Radiol. 1991 Sep-Oct;13(2):103-6.
Kallmes DF, Provenzale JM, Cloft HJ, McClendon RE. Typical and atypical MR imaging features of intracranial epidermoid tumors. AJR Am J Roentgenol. 1997 Sep;169(3):883-7.
Rodallec M, Colombat M, Krainik A, Kalamarides M, Redondo A, Feydy A. Diffusion-weighted MR imaging and pathologic findings in adult cerebellar medulloblastoma. J Neuroradiology. 2004 Jun;31(3):234-7.
Qiu SJ, Zhang XL. MRI features of 13 cases of intracranial ependymoma. Di Yi Jun Yi Da Xue Xue Bao. 2003 Nov;23(11):1224-5.
Warmuth - Metz M, Kuhl J. Neuroradiological differential diagnosis in medulloblastomas and ependymomas: results of the HIT'91-study. Klin Padiatr. 2002 Jul-Aug;214(4):162-6.
Lee YY, Van Tassel P, Bruner JM, Moser RP, Share JC. Juvenile pilocytic astrocytomas: CT and MR characteristics. AJR Am J Roentgenol. 1989 June;152(6):1263-70.
Coakley KJ, Huston J 3rd, Scheithauer BW, Forbes G, Kelly PJ. Pilocytic astrocytomas: well-demarcated magnetic resonance appearance despite frequent infiltration histologically. Mayo Clin Proc. 1995 Aug;70(8):747-51.
Koeller KK, Rushing EJ. From the archives of the AFIP: pilocytic astrocytoma: radiologic-pathologic correlation. Radiographics. 2004 Nov-Dec;24(6):1693-708.
Zimmerman RA : Neuroimaging of primary brain stem gliomas. Diagnosis and course.Pediatr Neurosurg 1996;25:45-53
Lee SR, Sanches J, Mark AS, Dillon WP, Norman D, Newton TH. Posterior fossa hemangioblastoma: MR imaging. Radiology. 1989 May; 171(2):463-8.
Zhou CW, Zhang HM, Ouyang H. Intracranial metastasis of malignant tumors: clinical characteristics and MR imaging features. Zhonghua Zhong Liu Za Zhi. 2004 Sep;26(9):554-7.
Tsuruda J.S., Chew W.M., Moseley M.E., Norman D.: Diffusion Weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors. AJNR Am J Neuroradiol. 1990;11:925-931.
Chen S, Ikawa F, Kurisu K, Arita K, Takaba J, Kanou Y. Quantitative MR evaluation of intracranial epidermoid tumors by fast fluid-attenuated inversion recovery imaging and echo-planar diffusion-weighted imaging. AJNR 2001;22:1089-1096.
Tadeusz W. Stadnik, Cristo Chaskis, Alex Michotte, Wael M. Shabana, Katrijn van Rompaey, Robert Luypaert, Lubos Budinsky, Vladimir Jellus, and Michel Osteaux. Diffusion-weighted MR Imaging of Intracerebral Masses: Comparison with Conventional MR Imaging and Histologic Findings. AJNR Am J Neuroradiol 2001 May;22:969-976,
Rumboldt Z, Camacho DL, Lake D, Welsh CT, Castillo M. Apparent diffusion coefficients for differentiation of cerebellar tumors in children. AJNR Am J Neuroradiol 2006;27:1362-1369.
Schneider JF, Confort-Gouny S, Viola A, et al. Multiparametric differentiation of posterior fossa tumors in children using diffusion- weighted imaging and short echo-time 1H-MR spectroscopy. J Magn Reson Imaging 2007;26:1390-1398.
Bulakbasi N, Guvenc I, Onguru O, et al. The added value of the apparent diffusion coefficient calculation to magnetic resonance imaging in the differentiation and grading of malignant brain tumors. J Comput Assist Tomogr 2004; 28:735-46.
Yamasaki F, Kurusi K, Satoh K, et al. Apparent diffusion coefficient of human brain tumors at MR imaging. Radiology 2005; 235:985-91
Murakami et al Grading astrocytic tumors by using apparent diffusion coeeficient parameters Radiology 2009;251(3):838-845.
Klatzo I. Presidental address: neuropathological aspects of brain edema. J Neuropathol Exp Neurol 1967;26:1-4.
Tien R, Felsberg G, Friedman H, Brown M, MacFall J. MR imaging of high-grade cerebral gliomas: value of diffusionweighted echoplanar pulse sequences. AJR Am J Roentgenol 1994;162:671-677.
Brunberg J, Chenevert T, McKeever P, et al. In vivo MR determination of water diffusion coefficients and diffusion anisotropy: correlation with structural alteration in gliomas of the cerebral hemispheres. AJNR Am J Neuroradiol 1995;16:361-371.
Plate KH, Breier G, Weich HA, Risau W. Vascular endothelial growth factor is a potential tumour angiogenesis factor in human gliomas in vivo. Nature 1992;359:845-848.
Folkman J. Seminars in medicine of the Beth Israel Hospital, Boston: clinical applications of research on angiogenesis. N Engl J Med 1995; 333:1757-1763.
Leon PS, Folkerth RD, Black PM. Microvessel density is a prognostic indicator for patients with astroglial brain tumors. Cancer 1996; 77:362-372.
Glantz MJ, Burger PC, Herdon JE II, et al. Influence of type of surgery on the histologic diagnosis in patients with anaplastic gliomas. Neurology 1991;41:1741-1744.
Belliveau JW, Rosen BR, Kantor HL, et al. Functional cerebral imaging by susceptibility contrast NMR. Magn Reson Med 1990;14:538-546.
Rosen BR, Belliveau JW, Aronen HJ et al. Susceptibility contrast MR imaging of cerebral blood volume: human experience. Magn Reson Med 1991;22:293-299.
Rosen BR, Belliveau JE, Vevea JM, Brady TJ. Perfusion imaging with NMR contrast agents. Magn Reson Med 1990;14:249-265.
Aronen HJ, Gazit EI, Louis DN, et al. Cerebral blood volume maps of gliomas: comparison with tumor grade and histologic findings. Radiology 1994;191:41-51.
Brant-Zawadski M. Pitfalls of contrast enhanced imaging in the nervous system. Magn Reson Med 1991;22:243-248.
Panigrahy, M.D. Krieger, I. Gonzalez-Gomez, X. Liu, J.G. McComb, J.L. Finlay, M.D. Nelson, Jr. F.H. GillesS. Blu¨ml. Quantitative Short Echo Time 1H-MR Spectroscopy of Untreated Pediatric Brain Tumors: Preoperative Diagnosis and Characterization. AJNR Am J Neuroradiol Mar 2006;27:560-72
Meng Law, Soonmee Cha, Edmond A. Knopp, Glyn Johnson, John Arnett, Andrew W. Litt. High-Grade Gliomas and Solitary Metastases: Differentiation by Using Perfusion and Proton Spectroscopic MR Imaging. Radiology March 2002;222:715-721
Sutton LN, Wang Z, Gusnard D, et al. Proton magnetic resonance spectroscopy of pediatric brain tumors. Neurosurgery1992;31:195-202.
Kugel H, Heindel W, Ernestus RI, et al. Human brain tumors: Spectral patterns detected with localized H-1 MR spectroscopy. Radiology 1992;183:701-9.
Kee-Hyun Chang, In Chan Song, Sung Hyun Kim, Moon Hee Han, Hong Dae Kim, Su Ok Seong, Hee Won Jung, and Man Chung Han. In Vivo Single-Voxel Proton MR Spectroscopy in Intracranial Cystic Masses. AJNR Am J Neuroradiol March 1998;19:401-405,
Kim M. Cecil, Ph.D. and Blaise V. Jones, M.D. Magnetic Resonance Spectroscopy of the Pediatric Brain. Topics in Magnetic Resonance Imaging 2001;12(6): 435-452
Janine M. Lupo, Suchandrima Banerjee, Kathryn E. Hammond, Douglas A.C. Kelley, Duan X, Susan M. Chang, Daniel B. Vigneron, Sharmila Majumdar, Sarah J. Nelson. GRAPPA-based susceptibility-weighted imaging of normal volunteers and patients with brain tumor at 7 T. Magnetic Resonance Imaging 2009;27: 480-488
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Faiz Mohammed
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
