Pontoserebellar köşe tümörlerinde dinamik kontrastlı manyetik rezonans görüntüleme bulguları

Amaç: Pontoserebellar köşe tümörlerinin konvansiyonel manyetik rezonans görüntüleme MRG ileayırıcı tanısı her zaman mümkün olmayabilir. Buçalışmada, dinamik kontrastlı MRG’nin akustik nörinom, meninjiyom ve paragangliyom ayırıcı tanısındaki rolü araştırıldı.Hastalar ve Yöntemler: Tanıları akustik nörinom n=3 , paragangliyom n=5 ve meninjiyom n=4 olan 12 olguda konvansiyonel MRG ile eşzamanlı dinamikMRG uygulandı. Bu olgularda kontrast sonrası T1Asekanslar öncesinde dinamik MRG elde edildi. Görüntülerde 15 ayrı zaman noktasındaki rölatif vemaksimum rölatif tepe kontrastlanma Kmaks değerleri ve bu değerlere erişmek için geçen süre Zmaks hesaplandı. Lezyonların zaman-sinyal intensite eğripaternleri karşılaştırıldı.Bulgular: Literatürde tanımlanan dört temel zaman- sinyal intensite eğrisine göre, akustik nörinomların tip C, meninjiyomların tip A ve tip B, paragangliyomların ise tip A ile uyumlu patern gösterdiği görüldü.Sonuç: Dinamik MRG’nin pontoserebellar köşe tümörleri gibi, ekstra-aksiyal intrakraniyal patolojilerinayrıcı tanısında sınırlı da olsa katkısı olabileceği düşünüldü

Dynamic contrast-enhanced magnetic resonance imaging findings of mass lesions of the pontocerebellar angle

Objectives: The differential diagnosis of mass lesions of the pontocerebellar angle is not always possible by conventional magnetic resonance imaging MRI . İn this study, we investigated the role of dynamic contrast- enhanced MRI in the differential diagnosis of acoustic neurinoma, meningioma, and paraganglioma.Patients and Methods: Twelve patients 8 females, 4 males; mean age 47.5 years; range 8 to 71 years whose diagnoses were acoustic neurinoma n=3 , paraganglioma n=5 , and meningioma n=4 were evaluated by simultaneous conventional and dynamic contrast-enhanced MRI. Prior to postcontrast Tr weighted images, dynamic MRI was obtained. On these images, maximum contrast enhancement Cmax and time to peak enhancement Tmax were calculated at 15 different time points. Time-signal intensity curve patterns of the lesions were compared.Results: According to the four main time-signal inten­ sity curve patterns described in the literatüre, acoustic neurinomas, meningiomas, and paragangliomas exhibited type C, type A-B, and type A curve patterns, respectively.Conclusion: Our results suggest that dynamic con­ trast MRI may have an additional but limited role in the differential diagnosis of extra-axial intracranial tumors such as those of the pontocerebellar angle.

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