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4.1b. Pre-contrast Axial 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. 4.2a. Post-contrast Axial T1 Wtd MRI. 4.2b. Post-contrast Coronal T1 Wtd MRI.

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slide1
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

slide2
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

slide3
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

slide4
Abnormal MRI with dural masses

Q4. Diagnosis Please

4.4. Post-contrast Coronal T1 Wtd MRI

slide5
Abnormal MRI

Q5. Diagnosis Please

4.5. Post-contrast Axial T1 Wtd MRI

slide6
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

slide7
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

slide8
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

slide9
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

slide10
4.3a. Pre-contrast Axial T1 Wtd MRI

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

slide11
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

slide12
50-year old male with renal cell carcinoma

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

slide13
METASTASES TO THE BRAIN

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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