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4.1a. Axial T2 Wtd MRI. 4.1b. Pre-contrast Axial T1 Wtd MRI. 4.1c. Post-contrast Axial T1 Wtd MRI. Patient with Intra-cranial mass. Q1. Diagnosis Please. 4.1d. Post-contrast Sagittal T1 Wtd MRI. 4.2a. Post-contrast Axial T1 Wtd MRI. 4.2b. Post-contrast Coronal T1 Wtd MRI.

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4.1a. Axial T2 Wtd MRI

4.1b. Pre-contrast Axial T1 Wtd MRI

4.1c. Post-contrast Axial T1 Wtd MRI

Patient with Intra-cranial mass.

Q1. Diagnosis Please

4.1d. Post-contrast Sagittal T1 Wtd MRI


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4.2a. Post-contrast Axial T1 Wtd MRI

4.2b. Post-contrast Coronal T1 Wtd MRI

Patient with multiple Intra-cranial masses.

Q2. Diagnosis Please


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4.3a. Pre-contrast Axial T1 Wtd MRI

4.3b. Post-contrast Axial T1 Wtd MRI

4.3c. Post-contrast Coronal T1 Wtd MRI

Abnormal MRI

Q3. Diagnosis Please

4.3d. Post-contrast Sagittal T1 Wtd MRI


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Abnormal MRI with dural masses

Q4. Diagnosis Please

4.4. Post-contrast Coronal T1 Wtd MRI


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Abnormal MRI

Q5. Diagnosis Please

4.5. Post-contrast Axial T1 Wtd MRI


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Fig. 4.1

Fig. 4.2

Fig. 4.3

Cases 4.1 through 4.5 share a common diagnosis.

Name the common diagnosis.

Fig. 4.4

Fig. 4.5


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Fig. 4.1

Fig. 4.2

Fig. 4.3

Cases 4.1 through 4.5 share a common diagnosis.

Name the common diagnosis.

METASTASES TO THE BRAIN

Fig. 4.4

Fig. 4.5


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E

4.1a. Axial T2 Wtd MRI

4.1b. Pre-contrast Axial T1 Wtd MRI

4.1c. Post-contrast Axial T1 Wtd MRI

56-year old lady with a history of Breast carcinoma presented with 1-month history of increased difficulty in word finding.

Findings: A well-defined enhancing tumor (arrow) is seen within the left frontal lobe with surrounding edema (E in figure A)

Diagnosis: Solitary metastatic adenocarcinoma to the brain from breast primary.

4.1d. Post-contrast Sagittal T1 Wtd MRI


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40-year old lady with a history of breast carcinoma diagnosed 6 years ago, presented with headache and ataxia.

Findings: Shower of at least 30 metastatic enhancing lesions are seen closely packed together within both Cerebellar hemispheres (yellow arrows) and few lesions also seen within both posterior Fronto-parietal lobes (red arrows)

Diagnosis: Multiple metastasis to the brain from breast primary


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4.3a. Pre-contrast Axial T1 Wtd MRI diagnosed 6 years ago, presented with headache and ataxia.

4.3b. Post-contrast Axial T1 Wtd MRI

4.3c. Post-contrast Coronal T1 Wtd MRI

Findings: Linear enhancement of the subarachnoid space outlining the cerebellar sulci (arrows in B, C, D) and cortical sulci (small arrows in C,D). Note the pathology is not seen in non-contrast study (A).

28-year old male with melanoma presented with severe headaches, treated by chiropractor without relief, and also with blurred vision progressed to diplopia.

Findings: Linear enhancement of the subarachnoid space outlining the cerebellar sulci (yellow arrows) and cortical sulci (red arrows). Note the pathology is not seen in non-contrast study (A).

Diagnosis: Leptomeningeal/subarachnoid spread of melanoma metastasis, proven by cerebrospinal fluid cytology.

4.3d. Post-contrast Sagittal T1 Wtd MRI


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69-year old male with prostate cancer diagnosed 7 years ago, presented with right sided hemiparesis.

Findings: Multiple enhancing dural masses involving the left frontal dura (short arrow) and left temporal dura (long arrow) with calvarial metastases (red arrows).

Diagnosis: Dural metastases from prostrate carcinoma

4.4. Post-contrast Coronal T1 Wtd MRI


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50-year old male with renal cell carcinoma presented with right sided hemiparesis.

Diagnosis: Right temporal calvarial metastasis with a small epidural tumor (arrow head) and an intraventricular metastasis (arrows).


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METASTASES TO THE BRAIN presented with right sided hemiparesis.

MRI is more sensitive than CT imaging to detect metastatic lesions and can detect a lesion as small as a dot (2mm).

Common primary sites:Lung, Breast, Melanoma, Thyroid, Renal Cell Carcinoma

  • Patten of involvement:

  • Intraparenchymal (Figure 4.1)

  • Leptomeningial/Subarachnoid Spread (Figure 4.3)

  • Dural (Figure 4.4)

  • Epidural (Figure 4.5)

  • Intraventricular (Figure 4.5)

Fig. 4.1

Fig. 4.3

  • Hemorrhagic Metastases

  • Renal

  • Breast

  • Melanoma

  • Choriocracinoma

Fig. 4.4

Fig. 4.5


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