Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuroradiology > Diffuse astrocytic and oligodendrogial tumors > Flashcards

Diffuse astrocytic and oligodendrogial tumors Flashcards

1
Q

Diffuse astrocytoma, IDH mutant

A 
ATRX, loss
T2/FLAIR hyperintense, expansile, involves both cortex and white matter
Vasogenic edema is absent
Non enhancing ?
Majority of diffuse astrocytomas
CDKN2A/B retained -> WHO grade 2 or 3
CDKN2A/B homozygotely deleted or necrosis/MVP -> WHO grade 4
FLAIR-mismatch, age <40, size >6cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Oligodendroglioma, IDH mutant and 1p/19q codeleted

A

ATRX retained
T1 hypo
T2/FLAIR hyperintense
expansile, indistinct margins, hetergenenous, involves both cortex and white matter, frontal lobe
Vasogenic edema is absent
SWI - blooming (calcifications)
CE - variable 50% and not prognostic
DWI - normal
Moderatly elevated rCBV
PET - FDG - if as gray matter or MET/FET anaplastic
MRS - moderate Cho, decreased Naa, no lactate (anaplastic have lactate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pilocytic astrocytoma

A

WHO grade 1
BRAF-fusion - MAPK-pathway - good prognosis
Most common pediatric tumor and most common pediatric cerebellar tumor
NF-1 (PA, optic pathway glioma)
expansive - cerbellum (60%)/cerebral hemispheres
- well circumsribed with solid part (T2/FLAIR hyper, T1 hypo, intense CE) and cystic part (+/-wall enhancement, fluid content (follows CSF)). No edema
infiltrative - elongating and widening of the optic nerve, T2 hyper, moderate CE
MRS - high Cho, latate doublets
DWI - high ADC
PWI - low rCBV, first-pass curve
new - high grade astrocytoma with piloid features (IDH wt, CDKN2A/B, ATRX)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pilomyxoid astrocytoma

A 
WHO grade 2
BRAF V600E (substitution)
Young children 
Hypothalamus/optic chiasm (60%)
T2 hyper
DWI - high ADC
SWI - hemorrhage 20%
intese heterogenous CE
CSF dissimination is common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pleomorphic xhantoastrocytoma

A 
WHO grade 2-3
BRAF V600E (substitution)
Young adults
cortical temporal lobe
seizures
dural attachement/tail
well circumscribed
Solid component (iso on CT, T1 and T2, FLAIR hyper)
CE homo/heterogeneous 
marked vasogenic edema
50% cysts
associated with cortical dysplasia, ganglioglioma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ganglioglioma

A 
WHO grade 1
BRAF V600E (substitution)
most common glionerual neoplasm, 1% of intracranial tumors
glial component affects the biological behavior
temporal, frontal lobe
shrply/poorly margins, solid/cystic/ cyst with a nodule
CT - low density
no edema
Ca 35%
erosion of inner table of scull
T2 hyper
T1 variable signal
CE - variable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hemangioblastoma

A

flow voids
peritumoral edema
elevated rCBV (8-10)
vHL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ependymoma

A

Anywhere in the CNS, posterior fossa
1-6y (supratentorial 18-24y)
3-5% of intracranial neoplasms
plastic - extends through foramina
Cysts
Calcification
Hemorrhage
DWI - mildly restricted
can seed
RELA - supratentorial, older children, poor prognosis
YAP1 - supratentorial, younger children, good prognosis
Posterior fossa A - young, lateral recess, poor prognosis
Posterior fossa B - older children, midline, good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Medulloblastoma

A

DWI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of temporal lobe epilepsy

A 
Mesial temporal sclerosis
Ganglioglioma -40%
DNET -20%
Diffuse low grade astrocytoma -20%
Other -20% (pilocytic astrocytoma, pleomorphic xantoastrocytoma, oligodendroglioma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Neurofibroma

A 
WHO grad 1
NF1
fusiform
no cyst/hemorrhage
T1 hypo
T2 hyper +/- hypo central (target sign)
CE - heterogenous mild or no enhancement 
3 types: localised intraneural (90%), diffuse cutaneous, plexiform
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Schwannoma

A 
WHO grade 1
Antoni A/B growth pattern
Local mass effect/nerve dysfunction
CN (not olfactory (filia) or optic), vestibulocochlear is most common
Round
Cysts/hemorrhage/fatty degeneration
Displace nerves
NF2/schwannomatosis
T1 iso/hypo
T2 heterogenous
SWI - hemosidering in larger tumors
CE - strong
Subtraction imaging for assessment of growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Meningioma of pontine angle

A 
Dural base
Dural tail
Isointense with gray matter
Perpendicular to nerves courses
Homogeneous enhancement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Multinodular and vacuolating tumor

A 
parietal and temporal
seizures
juxtacortical cluster of tiny well-defined nodules
T2/FLAIR hyper (ddx PVS)
no edema
no enhancement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dysembryoblastic neuroepitelial tumor

A 
Supratentorial
WHO grade 1
temporal and frontal
seizures
associated with cortical dysplasia
wedge shape, multycystic "bubbly"
T2 hyper
FLAIR - bright rim sign
enhancement 33%
no edema
remoddeling of adjecent bone
ddx: diffuse astrocytoma, oligodendroglioma, pleomorphic xanthoastrocytoma, ganglioglioma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Gangliocytoma

A

Supratentorial
very rare
exclusive ganglion cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Desmoplastic infantile ganglioglioma

A 
Supratentorial
Very large tumor in 1st year
frontal, parietal
both cystic and solid
poor prognosis
ddx: teratomas, choroid plexus papilloma, AT/RT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Papillary glioneural tumor

A

Supratentorial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Central neurocytoma

A 
Intraventricular (may be extraventricular)
WHO grade 2
Young and middle age adults
Third and lateral ventricles, attached to the septum pellucidum
Ca 50-70%
CT - mixed density
T1 iso
T2 bubbly
FLAIR heterogeneous
hydrocephalus is common
CE - moderate/heterogenenous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Rosette-forming glioneural tumor of the 4th ventricle

A

Infratentorial intraventricular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos)

A 
Infratentorial parenchymal
Cerebellum or vermis
WHO grade 1
T2 striate pattern (hyper/iso)
Cowdens syndrom (multiple hamartoma syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cerebellar liponeurocytoma

A

Infratentorial parenchymal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Paraganglioma

A

filum terminale
WHO grade 1
very rare
increased vascularity - feeding vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Myxopapillary ependymoma

A 
WHO grade 2 (2021)
children and young adults
glial cell of filum terminale
83% of primary tumors in that area
multiple in 43%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Embryonal tumors with multilayered rosettes

A 
C19MC 95% - amplification (cluster of fetal neural tubes)
LIN28A - if present poor prognosis
under 2 years
poor outcome
Cerebral hemispheres 76%, cerebellum, brain stem, pre-sacral space, optic nerve
Large 
heterogeneous (haemorrhage/Ca/cysts/necrosis)
may be exophytic
No edema
DWI - restricted
CE - mild/no
CT - hyperdense
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Atypical teratoid rhabdoid tumor

A

WHO grade 4
2% of CNS tumors in children 10% under 1 y, can be congenital
INI1 gene - loss of tumor suppression
BRG1 gene
somatic or germ line mutation (rhabdoid tumor predisposition syndrome, kidney, lugns, skin, liver)
if no mutation (CNS embryonal tumor with rhabdoid features)
posterior fossa 52%, supratentoral 39%, pineal, spinal, multifocal
intra/extra axial
marginal cyst, calcification, haemorrhages
DWI - restricted
PWI - increased
MRS - high Cho, lipid peak, no creatin/Naa
rapid growth
CE - may not enhance
DWI to look for metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Medulloblastoma

A

CT hyperdens
Calcification, haemorrhage, cysts, necrosis
T1
T2
Ce - no/homogeneous/inhomogeneous
DWI - restricted
SHH 25% hemispheric (A), mildine-intraventricular (B), midline-extraventricular/vermis (C)
WHT 11% midline - intraventricular (A), midline-cisternal (B), off-midline-intraforaminal (C), off-midline-intracisterna (D)
Group 3 + 4 65%, midline-intraventricular
MYC - poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Desmoplastic medulloblastoma

A

younger than 3y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Keratocytic odontogenic

A

primary odontogenic, most common, uni-or multicystic, PTCH, mandible, tooth displacement and tooth resorption, tendency of recurrence, GorlinGoltz syndrome (multiple), DWI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Ameloblastoma

A

primary odontogenic, second most common, partially solid/multicystic, BRAFV600, unerupted 3rt molar, locally invasive mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Odontogenic myxoma

A

primary odontogenic, multilocular, expansile, well defined borders, honeycomb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Odontoma

A

primary odontogenic, malformation (hamartoma) compound (tooth) or complex (doesn’t look like tooth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Osteoma

A

osteogenic, cortical, fronto-ethmoid, jaws (angle, coronoid process, condyle), Gardners syndrome (multiple)50-60y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Osteoblastoma

A

osteogenic, >2cm, cortical and cancellous, fronto-ethmoid, orbit or jaw, 20y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Chondroblastoma

A

chondrogenic, maxilla, mandible or skull base, lytic with areas of calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Osteochondroma

A

pedunculated exophytic bony projection of cortical and cancellous bone, condyle or coronoid process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Giant cell tumor

A

osteolytic +/-matrix calcification, hemorrhage, mandible, maxilla, ethmoid, sphenoid, temporal bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Fibrous dysplasia

A

Fibro-osseous lesions (+ ossifying fibroma, osseous dysplasia)
expansile proliferation of trabecular bone + fibrous tissue, maxilla, mandible, zygoma, spheno-ethmoid, externa cortical bone protrusions, notion of growth by Gd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Ossyfying fibroma

A

Fibro-osseous lesion (+ fibrous dysplasia osseous dysplasia)

fibrocellular and mineralized, mandible, maxilla, paranasal sinus. Demarcation and encapsulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Osseous dysplasia

A

Fibre-Osseous lesions (+ fibrous dysplasia ossifying fibroma)
replacement of bone by fibrous tissue and metaplastic bone, periodontal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Chondrosarcoma

A

chondrogenic, osteolyticm cortical destruction, calc soft tissue, alveolar maxilla, maxillary sinus, spetum zygomatic bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Osteosarcoma

A

osteogenic, lobulated, lytic,-mixed or sclerotic, alveolar maxilla, body mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Pleomorphic adenoma

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Adenocystic carcinoma

A

Malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Mucoepidermoid carcinoma

A

Malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Adenocarcinoma

A

Malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Dentigerous cyst (follicular cyst)

A

Pseudotumor, encloses crown of unerupted tooth, attaches to the cement-enamel junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Primoderal cyst

A

Pseudotumor, replace tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Residual cyst

A

Pseudotumor, following tooth extraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Inflammatory cyst (radicular cyst)

A

Pseudotumor, result of apical periodontitis, maxilla and mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Naso-palatine cyst

A

Non-odontogenic (fissural) cyst, developmental, foramen incisivum, sometimes unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Naso-alveolar cyst

A

Non-odontogenic (fissural) cyst, developmental, submucosal anterior to premaxilla, posterior to nasal ala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Simple bone cyst

A

Non-odontogenic pseudocysts, corticallated scalloped unilocular cyst in mandible, no root resorption, nonexpansile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Stafne cyst

A

Non-odontogenic pseudocysts, developmental defect anterior to angle of mandible, part of submandibular gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Perineural spread

A

most common in cutaneous and mucosal malignances (BCC, SCC), salivary gland malignancies (especially ACC), nasopharyngeal carcinoma, desmoplastic melanoma, lymphoma, leukemia and myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Diffuse astrocytoma, IDH wt

A 
WHO grade 4
Older, 
multifocal
brainstem
No cystic changes
DWI - restricted
CE - variable
PWI - difficult
MRS - 2HG IDH might be lowered
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Diffuse midline glioma

A 
H3.1/3, K27M, H3 27 wt
WHO grade 4
5-11y
poor prognosis
midline - thalamus, pons, spinal cord
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Gliomatosis cerebri

A

Growth pattern,

3 lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

T2-FLAIR mismatch

A 
Indicative of No CE IDH-m
in astrocytomas (not oligodendrogliomas)
T2 hyperintense
FLAIR hypo with hyperintense rim
ddx bright rim sign in DNET
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

MR-IDH status

A

T2-FLAIR mismatch - IDHm
DWI - restricted - IDHwt
MRS - 2HG - IDHm

61
Q

Glioblastoma

A

most common malignant brain tumor
Intraaxial, gray+white matter, more frequent supratentorial
CE - solid/necrotic/cystic, non spherical
PWI - rCBV >1.75, increased permeability, high CBF
SWI - intratumor suseptibility (necrosis/hemorrhage + vessels)
DWI - variable, often restricted diffusion
non-enhancing tumor - WM, may involve GM, MRS - Cho peak, APT, DWI and PWI may be abnormal

62
Q

Abscess

A

DWI - restricted in necrosis

PWI - DSC no angiogenisis

63
Q

Acute demyelination lesion

A 
Low mass effect
incomplete ring
look for other lesions
DWI - varaible
PWI - normal rCBV in enhancing part
64
Q

Subacute infarct

A

high T1 in cortex
gyriform enhancement
PWI - normal rCBV in enhancing part
SWI - low cortical signal

65
Q

PWI - rCBV

A

High - glioblastoma, high-grade glioma, metastasis, medulloblastoma, capillary telangiectasia
Low - lymphoma, desmoplastic medulloblastomas, pilocytic astrocytoma, vascular, traumatic contusion, inflammation, abscess

66
Q

Lymphoma

A

Solid enhancement (rarely necrotic/HIV)
DWI - restricted
PWI - rCBV normal or low, high K2
SWI - normal

67
Q

Metastasis

A

Solid or necrotic, spherical
MRS - lipids
PWI - high rCBV
Edema - centered by the lesion, marked T2/FLAIR, no mass effect, facilitated DWI, low PWI, normal MRS

68
Q

Subependymoma

A 
0.5% of intracranial neoplasms
fourth ventricle, lateral ventricle
50-60y
WHO grade 1
well circumscribed, cysts are common, can calcification/haemorrhage
CE - no or minimal
No CSF seeding
69
Q

Choroid plexus tumors

A 
<5y (2-4% of paediatric brain tumors)
trigone of lateral ventricle
Papilloma - WHO grade 1
Atypical papilloma - WHO grade 2
Carcinoma - WHO grade 3
Cauliflowerlike lobulated mass, can haemorrhage/calcifications/necrosis
Hydrocephalus is common
CSF seeding
CE - present
70
Q

Subependymal giant cell tumor

A 
Foramen of Monroe, well marginated, lobulated, heterogenenous (calcifications)
15% of patients with TS
WHO grade 1
No CSF seeding
CE - strong
Hydrocephalus
71
Q

Intraventricular meningioma

A 
Atrium of lateral ventricle
30-60y
Slow growing (large size)
Can cyst/calcification
CT iso/hyper
Local CSF-obstruction
72
Q

Central neurocytoma

A 
0.5% on intracranial neoplasm
Septum pellucidum or lateral wall of lateral ventricle
Well circumscribed lobulated mass, bubbly, can haemorrhage/calcifications
CT hyper
CE - variable
29y
Hydrocephalus
WHO grade 2

Synaptophysin stain

73
Q

Rosette-forming Glioneural tumor

A 
Rare
WHO grade 1
31.5y
Hydrocephalus
Fourth ventricle
Fairly well circumscribed, heterogeneous solid and cystic
74
Q

CSF drop metastasis

A 
Ependymoma
Choroid plexus tumors
Germinoma
Medulloblastoma
Pineoblastoma
Enedymal invasion - GBM
75
Q

Craniopharyngeoma

A

craniopharyngeal duct remnant - floor of third - pituitary
10-14y/40-60y
Cystic/solid with variable signal in cysts, can calcification
T1 hyper
CE - solid nodules

76
Q

Germinoma

A 
child/young adults
Pineal and/or hypothalamus
T2 hyper
CE - homogeneous
CT - slight hyper
77
Q

Meningioma

A

15-20% of intracranial tumor in adult
Arachnoid cap cells/meningocytes
50% falx, parasagittal, lateral convexity
40% basal, subfrontal, olfactory groove, sphenoid wing and suprasellar
Dural based, CSF cleft, widening of subarachnoid spaces, intervening vessels, dural tail, hyperostosis (reactive hypervascularity)/erosion of calvarium
CT - hyperdense
T1 iso/hypo
T2 iso/hyper
CE - homogeneous, in bone - intraosseous
Edema 60%
Hemorrhage is rare
WHO grade 1, 2 (atypical, papillary, rhabdoid) and 3 (anaplastic - may infiltrate of brain)
Look for vascular encasement, venous infiltration, hypervascularity

78
Q

Epidermoid

A

CSF like on CT, T1 and T2

DWI - restricted

79
Q

Hemangiopericytoma

A 
Younger than meningioma
Agressive tumor
CE - vivid
T2 - flow voids
Narrow base of dural attachment
Edema in adjacent brain
80
Q

Primary CNS lymphoma

A

B-cell 90%
45-70y
immunodeficiency
Parenchymal mass close to surface
T2 hypo
DWI - restricted (EBV hyperintense rim)
Solitary or multiple (50%)
CE - homogeneous, ring (HIV, EBV - 90%), perivascular, ascent
Hemorrhage (HIV, EBV - 70%)
steroid treatment - tumor regression, decrease CE and rCBV and increase ADC
Differentiate from GMB: ADC, rCBV and FDG-PET
Cave - post treatment T1 hyper
Treatment - MATRIx - response DWI, PWI and FDG-PET

81
Q

Secondary CNS lymphoma

A

10-15% of NHL
More frequent in relapsing disease
2/3 leptomeningeal, 1/3 parenchymal
CE - leptomeningeal, dural, subependymal, CN

82
Q

Leukaemia

A

ALL - children - CNS profylax is standard
AML - adults
Leptomeningeal and CN infiltration
Granulocytic sarcomas (chloromas) - intraparenchymal, CE - strong, DWI - restrict, can be hemorrhagic, dural based, calvarium, orbit, sinuses
Cerebral hemorrhage
Bone marrow infiltration

83
Q

Neurofibromatosis Type 1

A

1/3000
Cafe-au-lait, neurofibroma/plexiform neurofibroma, axillary/ingunial freckling, optic nerve glioma (PA, 4-5y), Lisch noduli, sphenoid dysplasia, relative with NF1
Gliomas in NF1 - brainstem (diffuse/focal) medullary, pontine, midbrain
UBO - appear at 3-4y and disappears 10-12y - no mass effect or CE, MRS - preserved Cho/Naa ratio
Gliomas - slow progression, might regress
Moyamoya, arteria ectasia and aneurysm

84
Q

Plexiform neurofibromas

A

WHO grade 1
Tortuous, aggressive, infiltrating the nerves
T1 iso to muscle
T2 hyper, inhomogeneous
CE - inhomogeneous
10% malignant peripheral nerve sheath tumor

85
Q

Spinal neurofibroma

A

Scoliosis
NF1
Dumbell

86
Q

Neuroblastoma

A

Peripheral nerves
7-8% of paediatric tumors
<5y

87
Q

Neurofibromatosis Type 2

A

1/25000
Merling
MISME (multiple inherited schwannomas, meningiomas and ependymomas)
Bilateral schwannomas or relative with NF2
Meningiomangiomatosis - rare hamartomatous lesion

88
Q

Tuberous Sclerosis Complex

A

1/6000
Hamartin, Tuberin
Cortical tuper (=focal cortical dysplasia), often calcification
WM abnormalities - transmantal sign
Subependymal nodules - lateral wall of lateral ventricle, candle guttering, calcification common, may enhancement
SEGA - foramen of monroe, 2-26%, rapamycin

89
Q

Sturge-Weber

A

Facial capillary vascular malformation - trigeminal territory
Leptomeningeal angiomatosis - multiple thin vessels in leptomeninges - enhancement of cortical surface - atrophy and calcifications
Angiomatosis of the choroid of ipsilateral eye
Hypertrophy of choroid plexus
No tumor

90
Q

Von Hippel-Lindau

A

Systemic

Hemangioblastoma - highly vascularised nodule that abuts the pial surface cystic component (reactive)

91
Q

Hemangioblastoma

A 
highly vascularised nodule that abuts the pial surface cystic component (reactive)
Cherry on angiography
T1 hypo
T2 hyper
CE - strong, non enhancing cyst wall
PWI - high rCBV
92
Q

Neurocutaneous syndroms

A 
NF1 - PA, neurofibroma
NF2 - schwannoma, meningioma, ependymoma
Tuberous sclerosis - subependymal giant cell astrocytoma
Sturge-Webe syndrome - none
Von Hippel Lindau - hemangioblastoma
93
Q

Spinal Ependymoma

A 
40-50y (NF2 - children)
T2 hyper
T1 hypo
85% central
CE - vivid
Well defined borders, neoplastic cysts (tumoral/non tumoral)
30% cap sign
94
Q

Myxopapillary ependymoma

A 
Conus and cauda
WHO grade 1
multilobulated, cystic, haemorrhage
CE - always
Scalloping of vertebral bodies
CFS spread
95
Q

Spinal Astrocytoma

A 
30-40y (most common intramedullary tumor in children, PA)
Fusiform expansion of cord
T1 iso/hypo
T2 hyper
inhomogeneous, illdefined margins
CE - heterogeneous, 60-70%
May have haemorrhage
30% satellits cysts
96
Q

Spinal Hemangioblastoma

A

Benign, rich vascularised (flow void)
2-6% of spinal tumors
If multiple - vHL
small nodule with extensive edema or extensive cyst

97
Q

Intramedullary metastasis

A

Edema
T1 iso
T2 hyper
CE - nodular

98
Q

Intramedullary epidermoid

A

“cholesteatoma”
1%
slow growing, lumbosacral, dermal sinus in children
congenital or acquired

99
Q

Melanocytoma

A 
Leptomeningeal melanocytes, intradural extramedullary
WHO grade 1
T1 hyper
T2 hypo
CE - uniform
100
Q

Spinal Meningioma

A

Intradural, extramedullary
80% thoracic (posterolateral), 15% cervical (anterior)
50-60y
T2 hyper
T1 iso/hypo
CE - vivid, homogeneous
well circumscribed, delineated from the spinal cord

101
Q

Spinal nerve sheath tumor

A

60% intradural extramedullary, 25% extradural, 15% both
cervical or lumbar
schwannoma 65%, neurofibroma, ganglioneuroma (rare)
40y
T1 iso
T2 hyper, sometimes target sign
CE - variable

102
Q

Spinal neurofibromas

A

Neurofibromin
NF1
T2 target sign
CE - central or heterogeneous

103
Q

Spinal schwannomas

A 
= neurinoma
Merlin
NF2
hemorrhage, cyst
CE - diffuse
104
Q

Paraganglioma

A 
Adrenal (pheocromocytoma), carotid body and gloms jugular
Conus, cauda and filum
30-60y
WHO grade 1
SDHD - mutation
T1 iso
T2 hyper
inhomogeneous, haemorrhage, intratumoral and adjacent vessels with flow void and strong enhancement
105
Q

Spinal eosinophilic granuloma

A

0-10y, vertebral body

106
Q

Spinal osteoid osteoma

A

10-20y, posterior elements

107
Q

Spinal aneurysmatic bone cyst

A

10-20y, involvement of adjacent levels, posterior elements

108
Q

Spinal giant cell tumor

A

20-50y, involvement of adjacent levels, vertebral body, posterior elements

109
Q

Plasmacytoma

A

40-60y, involvement of adjacent levels, vertebral body

oval with sharp margins in scull base, clivus and petroclival

110
Q

Chordoma

A

40-60y, involvement of adjacent levels, vertebral body

111
Q

Spinal hemangioma

A

40-60y, multiple lesions, vertebral body

112
Q

Multiple myeloma

A

50-70y, multiple lesions, vertebral body

113
Q

Spinal metastasis

A

50-70y, multiple lesions, vertebral body

114
Q

Spinal lymphoma

A

Multiple lesions, involvement of adjacent levels, vertebral body

115
Q

Spinal sarcoma

A

Involvement of adjacent levels, posterior elements

116
Q

Spinal metastasis

A

Arterial seeding, retrograde venous or direct extension
SPECT - osteoblastic
WB-MRI and/or PET

117
Q

Malignant spinal bone tumors

A

Lytic without marginal sclerosis
surrounding bone edema
invasion of neighbouring structures
Diagnostic clues: multiplicity, age, imaging characteristics and location

118
Q

Normal red marrow

A

<6 moths - low/homogeneous, no enhancemnet
6 months - 45y - intermediate/homogeneous, very limited enhancemnet
>45 y - intermediate/heterogeneous, no enhancement (high SI - more fat, low SI - more cells)

119
Q

Bone marrow metastasis

A

Decreased signal =

120
Q

Spinal hemangioma

A 
T1 high to low
T2 high
Fat-sat-fluid-sensitive - high
CE - yes
CT - polka dot
121
Q

Benign notochord cell tumor

A 
T1 low
T2 high
Fat-sat-fluid-sensitive - intermediate
CE - no
Small, sclerotic, hydrated, non-enhancing
122
Q

Focal red marrow hyperplasia

A 
T1 low
T2 low
Fat-sat-fluid-sensitive - intermediate
CE - subtle
signal as cellular red marrow
CT - normal/subtle sclerosis
123
Q

Ethmoid mucocele

A

Completely opacified and expanded sinus (cell)

124
Q

Allergic fungal sinusitis

A

Expanded sinuses with hyper dense stuff
Images /symptoms mismatch
Teenagers

125
Q

Encephalocele

A 
Ideopathic intracranial hypertension
Lateral sphenoid  (NOT sternbergs canal)
126
Q

Persistant craniopharyngeal canal

A

.

127
Q

Inferior median clival canal

A

= canalis basilaris medianas, fossa naviculars

128
Q

Ecchordosis physaliphora

A

Remnant of notochord
T1 hypo
T2 hyper
CE - variable

129
Q

Chordoma

A

From clivus, osteolytic, hypodense, may be off midline
T2 very high
DWI - very high ADC
CE - variable (minimal)

130
Q

Chondrosarcoma

A

Petroclival junction (cartilage)
whirls of calcs 50%
CE - stippled
DWI - very high ADC

131
Q

Hemangioma of cavernous sinus

A

T2 very high
DWI - very high ADC
CE - avidly enhancement

132
Q

Glomus jugulare

A

Enhancing mass with flow voids

Infiltrative osteolysis

133
Q

Jugular schwannoma

A

Smooth bone remodelling
DWI - high ADC
T2 hyper
CE - avid

134
Q

Endolymphatic sac tumor

A 
T1 hyper
T2 hyper
Infiltrative, osteolytic
Centered at endolymphatic duct
CE - heterogeneous
135
Q

Cholesterol granuloma

A

Smooth, sharp
Petrous apex expansion
T1 hyper
T2 hyper, hemosiderin rim

136
Q

Arachnoid granulations

A

Along sinuses
Lobulated bone remodeling
Not always T2 hyper

137
Q

Pituitary adenoma

A

CE - less and more slow than normal pituitary

Ddx - meningioma ehnacenes more than pituitary, reduces artery

138
Q

Cavernous angioma

A

CE - centripetal

139
Q

Rathke cleft cyst

A

mucoid 25%

intracystic nodules

140
Q

Head and neck lymphoma

A

Type 1 - nodal
Type 2 - extranodal (waldeyers ring/outside waldeyers ring)
Type 3 - combined 1+2
Type 4 - multifocal extranodal

nodes 2-10cm
CE - variable (less than reactive)
necrosis
calcifications after treatment

Reactive - multiple, well defined, mild enhancement, ADC >1 (metastasis larger, necrosis, ADC>0.7)

HL - 90% nodal, T2 hyper
NHL - multiple, bilateral solid, CE - moderate (retropharyngeal, occipital, parotid, posterior triangle, submandibular), T2 iso
5% of salivary tumors, parotid 70%
Ocular adnexa >60y most common orbital malignancy

141
Q

Mucocele

A

thin rim of the bone

MR signal, CT density variable

142
Q

Inflammatory pseudotumor

A

rare, benign

nonspecific imaging - rule out other lesions

143
Q

Dacroadenitis

A

OID
gland, orbital and palpebral lobes,
almond shape

144
Q

Myositis

A

OID
unilateral thickening of one or two EOM
superior oblique
surrounding fat, tenons and myotendinous junction
ddx: thyroid (I’m slow), cellulitis (CT), CCF (enlarged vein), metastasis (focal mass), lymphoma (focal mass, ADC)

145
Q

Optic perineuritis

A 
OID
optic nerve sheath
pain
CE - enhancement of sheath and adjacent fat
ddx: meningioma, optic neuritis
146
Q

Optic meningioma

A

Tram-track
no pain
CT - calcifications

147
Q

Optic neuritis

A 
spare soft tissue
different vision imparement
swollen nerve
T2 hyper
CE - contrast enhancement
148
Q

Periscleraitis

A

sclera, uvea and tenons capsule

thickening along the outer rim of the eye, periscleral fluid collection

Neuroradiology (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions