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Neuroradiology > extra axial masses > Flashcards

extra axial masses Flashcards

1
Q

What is the presumed reasoning for increased incidence of meningioma in middle aged women?

A

increased sensitivity of tumoral arachnoid cap cells to sex hormones

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2
Q

Where are the common locations for meningioma?

A 
Parasagittal/falcine - 50%
Sphenoid wing 20%
Anterior cranial fossa - 10%
Parasellar 10%
Tentorium and CPA
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3
Q

Can meningioma erode bone?

A

YES

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4
Q

What are the two main DDX for meningioma?

A

Mets

Sarcoid

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5
Q

What is the MR spec appearance of meningioma?

A

peak at 1.5ppm corresponding to alanine

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6
Q

What makes up epidermoid cysts? Dermoid?

A

Intracranial inclusion of epithelial elements during neural tube closure

Intracrainal inclusion of ectodermal elements during neural tube closure

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7
Q

Where are epidermoids usually found?

A

CPA - 50%
Sella and parasellar 10-15%
4th ventricle and prepontine cistern

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8
Q

When an epidermoid is found in children in the posterior fossa, what should be considered?

A

Klippel fleil syndrome and the possibility of infection

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9
Q

Where do dermoids occur usually?

A 
Lumbar spine
Parasellar region
Floor of anterior cranial fossa
Post fossa including 4th ventricle
Fontanelles
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10
Q

What is the imaging appearance of dermoid? What is the risk with rupture?

A

Matches fat on all sequences

Chemical meningitis due to leakage of contents into CSF space

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11
Q

Where do lipoma occur in the head?

A

80% midline

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12
Q

What is the appearance of pericallosal lipoma?

A

Calcification

Curvilinear with a normal appearing corpus callosum

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13
Q

What age group get choroid plexus tumors?

A

85% are

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14
Q

Where do choroid plexus papilloma occur in kids vs adults

A

Kids - atrium of lateral ventricle

Adults - 4th ventricle

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15
Q

Who gets choroid plexus carcinoma? When are they suspected?

A

Kids only

Surrounding edema and invasion of the parenchyma

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16
Q

What is the main differential for choroid plexus tumor?

A

Ependymoma, meningioma, mets, astrocytoma

17
Q

When should one suspect a choroid plexus tumor?

A

Solid vascular tumors in the 4th vent (adults) and lateral ventricle (kids) with vivid frond like enhancement and speckled calcification

18
Q

What percentage are active? With which hormone most commonly?

A

75-80%, prolactin

19
Q

What serum levels of prolactin will have a visible mass in MR? What level suggests cavernous sinus invasion?

A

200

1000

20
Q

What are the two types of craniopharyngioma?

A

Adamantinomatous (cystic, in kids)

Papillary (solid, adults)

21
Q

What is the imaging of a craniopharyngioma?

A

Calcifying enhancing cystic lesion in the sella midline

22
Q

What is the classification of pineal tumors?

A

By germ cell

23
Q

What is the most common type of pineal tumor?

A

Germinoma

hyperdense CT
low ADC/T2/FLAIR, avidly enhance

24
Q

What is the age group for pinealblastoma?

A
25
Q

What is the MRS of pinealblastoma?

A

No neurons, so no NAA

26
Q

Where do colloid cysts usually arise?

A

anterosuperior third ventricle

27
Q

What are the symptoms of colloid cyst?

A

Positional headache due to moving colloid ball that obstructs the foramen of munro

28
Q

What is the imaging of colloid cyst?

A

Low t1 high T2 due to proteinaceous material

Fried egg appearance with nodule of high or low signal intensity

29
Q

Where is the most common site for arachnoid cyst?

A

Middle cranial fossa and sylvian fissure

30
Q

What are the secondary signs of arachnoid cyst?

A

Scalloping adjacent bone change
Balloon valve mechanism
Production of CSF

31
Q

What conditions are associated with multiple arachnoid cysts?

A

Glutaric acidura
Tuberous sclerosis
MPS

Neuroradiology (15 decks)

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