2 Course ECONR
Braintumors oder Tumorlike diseases
Braintumors oder Tumorlike diseases
Which tumor calcify spinal
ganglioglioma
DD spinal schwannoma - menigeoma
Menigingeoma konvex to dura
Hemangioblastoma
dorsal aspect of conus
mostly interemdullary
hypervascular
posterior spinal
VHL
Which tumors can do drop mets
Ependymoma
GBM
Medulloblastoma
Gangion of SCarpa
Gangion of N vestibularis where Schwannoma beginns
What does the surgeon want to know in schwannoma
growing
on which nerv
where is facial nerv
can i preserve the hearing (lower intens means very hard preserv hearing)
Why can be fluid in cochlea be lower in schwannoma
Schwannoma can bloc vasa vasorum und more protein come up
Can you have Schwannoma of the den N I
yes ther are filiae in the lamina cribriforame
Most selden nerv with schwannoma
N VI
What signal does have neuroma (chron defektt of nerv)
T1 hyperintesn
Tumor on Nerv without enhancement
Neurofibroma
Tumor on Nerv without enhancement
Neurofibroma
Hemangiom on which nerf at most?
Gangion geniculi N VII
Calcifing nerv DD
hämangioma
Menigeoma
DD more than 1 nerv enhancung along
Met
Lymphoma
Leukemia
leptomeniosis and more nerv enhancing think of
sarcoid
Spinal Ependymoma more tumor oder reativ cyst
Astrozytoma
Ep: reaktiv
Astro: tumor
Oedem in Menigeoma
Secretiv Menigeoma
Kongestion of veins
malignacy
pial infiltration
Wie lange dauert es bis ligamnetiertes /embolisitertes Menigneom rekrutiert wieder neue Gefässe
2 Tage
Wie lange muss NCH warten bis Menigeom weichmit Nekrosis
5-7 day
Normaler Proteingehalt Liquor
150-450 mg/l
Kommen GBM cerebellär häufig selten
selten
Wann haben Oligodentrogliome schlechte Prognose
loss of 1p or 19q
Bestimmt Anreicheurng Prognose von
Oligodentrogliomen?
Astrocytomen?
Oligo nein,
Astro ja
Nenne Neuronale und mixed neurogliale Tumoren
Gangliogliomas
Dysembryoplastic neuro-epithelial
tumors
Central Neurocytoma
Dysplastic cerebellar gangliocytoma
Desmoplastic Infantile astrocytoma
Charakteristika DNET
Young
pelotting calvarian
"hamartuos"
cortical dysplasia
cystic
Circumscribed Astrocytoma
Pilocytic Astrocytoma
Subependymal Gaint Cell Astrocytoma
Pleiomorphic Xanthoastrocytoma
Pilocytic astrocytoma Charakteristika
Most common glioma in children
Corresponds to WHO grade I
Most frequent locations are:
- Cerebellum: 85%
- Hypothalamic/third ventricular region
- Optice neve/chiasm
- Dorsal brain stem
*
Pilocytic astrocytoma: imaging characteristica
Cerebellar
large cyst with mural nodule
nodule enhances strongly
Midline tumours
solid mass
diffuse enhancement, possibly heterogeneous
small cysts possible
Subependymal giant cell
astrocytoma charactersic
Mostly associated with tuberous sclerosis
Other signs of tuberous sclerosis (cortical
tubers, subependymal calcifications)
present
Rounded, calcified and strongly enhancing
mass near the foramen of Monro
Frequently (acute) hydrocephalus
Pleiomorphic Xantho-Astrocytoma characteristic
Rare tumors of children and young adults
Cerebral hemispheres, mostly temporal
Can be malignant
Can present as:
- cyst with a mural nodule which is
attached to the leptomeninges
- solid mass
Enhancement is intense and represents
hypervascularity
GBM enstehungsarten
siehe Bild
Wichitgkeit Enhancement Astrozystom
Is considered essential:
For characterising a new lesion as
malignant
For diagnosing malignant
transformation of a previously benign,
non-enhancing lesion
Non-enhancing tumors are
considered grade II
Wieviele % der nicht anreichernden Tumoren sind Anaplastisch?
40% (obwohl eine nicht anreicherung für gewöhnlichs Grad II angebenen wird
Oligodendroglioma Characteristik
Slow-groing tumor with propensity to
involve the cortex
Very heterogeneous tumor making
histologic grading difficult
Mixed oligo-astrocytoma is frequent
Genetics are very important. Loss of 1p and
19 q dramatically changes (improves) the
prognosis of the patiënt
Oligodendroglioma: 1p
Oligodendroglioma imaging characteristics
Most important imaging hallmarks are:
Cortical location or extension
Streaky calcifications imaging characteristics
- are not mandatory
- can have a very misleading appaerence on MR
Patchy or more diffuse enhancement that
does not necessarily represents
malignant transformation!!
*
Ependymoma charactersitric
Infratentorial: mostly in children
fourth ventricle
calcification frequent
platicity: lateral extension through foramen of
Luschka
inhomogeneous enhancement
Adult Ependymoma
Is mostly supratentorial
If totally intraventricular: to be
differentiated from central neurocytoma,
meningioma, astrocytoma
If not totally intraventricular
(70 % in adults) : can be indistinguishable
from malignant astrocyoma
Calcification frequent
*
Choroid plexus papilloma
Arise from choroid plexus epithelium
Comprise benign papilloma (grade I)
and carcinomas (grade III)
Lateral ventricle: 80 % children
Can produce CSF with hydrocephalus
Choroid plexus papilloma: imaging
Cauliflower-like intraventricular mass
Calcification frequent
Marked enhancement
-
- 1 / 238
-
Flashcards
DD Dnet
Angiocentric Glioma
hyperintens rim around Lesion
(DNET -> rim in FLAIR)
Medulloblastoma extended nodularity -> syndrom?
Gorlin
Good response to chemotherapie
Targetsign post KM
Toxoplasmosis
Kryptokokosis
Echordosis physaliphora
incidenal findung
notochorsal restat dorsal wall of clivu
Nenne intradurale extramedulläre Tumoren
Schwannoma
Neurofibroma (Traget cell)
Paraganglioma
Menigeoma
Ependymoma
Myxopapilläry Ependymoma
WHO?
I
Bei wievielen Pat ist eine WS Meta erste Manifestation eines Tumorleidens
20%
Sensitivity Mets in spine with CT
only 66%
Wieviele % befall sind gefährlich für kollaps
BWS
LWS
BWS mit befall costoverterbal?
LWS mit hinterem Boge
BWS >60%
LWS 40%
BWS CV: 30%
LWS hint Bogen: 25%
Peaks at ppm
Na
Cr 1
Cr2
Lipid
Lactat
Cholin
Na 2.0 (Neuronmakrer)
Cr1 3.03 (Energie)
CR2 3.9
Cho 3.25 (Cell membran tu
Lac 1.32 (Hypoxia)
Lipid 1.3 (cell nekrosis)
Inisitol 3.56 (Astomarker)
Verteilung intraspinale Tumoren
intramedulläre 10%
intradural extremar 30%
extradural 60%
Tumors intramedullary
Astrozytoma 90%
Hemangioblastoma 5%
Mimics 5%
Most common spinal cord tumor in children
Astrozytoma
Why are the spinal tumor mostly big at detection?
low symtoms
Does spinal tumors show enhancement?
almost all in some way
Types of ependymoma spine
cellular type
well subscripes, cyst and hemoorhage, rare calcification
myxopapillary
conus filum
cap sign?
bleeding at the ends of ependymoma
Hemangioblastoma in spine - where
5% of VHL Pat hat thies
thoracal>cervical
1/3 are associated with VHL
Which tumor calcify spinal
ganglioglioma
DD spinal schwannoma - menigeoma
Menigingeoma konvex to dura
Hemangioblastoma
dorsal aspect of conus
mostly interemdullary
hypervascular
posterior spinal
VHL
Which tumors can do drop mets
Ependymoma
GBM
Medulloblastoma
Gangion of SCarpa
Gangion of N vestibularis where Schwannoma beginns
What does the surgeon want to know in schwannoma
growing
on which nerv
where is facial nerv
can i preserve the hearing (lower intens means very hard preserv hearing)
Why can be fluid in cochlea be lower in schwannoma
Schwannoma can bloc vasa vasorum und more protein come up
Can you have Schwannoma of the den N I
yes ther are filiae in the lamina cribriforame
Most selden nerv with schwannoma
N VI
What signal does have neuroma (chron defektt of nerv)
T1 hyperintesn
Tumor on Nerv without enhancement
Neurofibroma
Tumor on Nerv without enhancement
Neurofibroma
Hemangiom on which nerf at most?
Gangion geniculi N VII
Calcifing nerv DD
hämangioma
Menigeoma
DD more than 1 nerv enhancung along
Met
Lymphoma
Leukemia
leptomeniosis and more nerv enhancing think of
sarcoid
Spinal Ependymoma more tumor oder reativ cyst
Astrozytoma
Ep: reaktiv
Astro: tumor
Oedem in Menigeoma
Secretiv Menigeoma
Kongestion of veins
malignacy
pial infiltration
Wie lange dauert es bis ligamnetiertes /embolisitertes Menigneom rekrutiert wieder neue Gefässe
2 Tage
Wie lange muss NCH warten bis Menigeom weichmit Nekrosis
5-7 day
