Brain Tumor…

April 25, 2013

CNS, Head, MRI, Non-Trauma

Here is an MRI head on a patient with a headache and newly diagnosed brain mass:

MRI brain tumor

This is a T2 weighted MRI.  T2 weighting is particularly good at showing edema.  Simple fluid enhances and appears bright on the image.  Above you can see the tumor arising near the peripheral parietal area with a good amount of surrounding bright fluid consistent with edema.  Note that the edema shows up similar to the patient’s normal CSF in the ventricles. 

If you add contrast to the study (gadolinium) and T1 weight the image this is what you’ll see:

Brain Tumor 2

In T1 weighted imaging simple fluid is darker but in this case the tumor outlines very well with gadolinium.  This imaging is particularly good at picking up smaller tumors without large amounts of surrounding edema.  In this case several other smaller lesions were easily identified with T1 gadolinium imaging including one seen in the midbrain:

Midbrain 1

These turned out to be a metastatic lesions likely from the lung.  Metastases are the most common clinically important brain malignancies found outside of the pediatric population (the exact incidence of non-clinically apparent. 

Author:  Russell Jones, MD

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EMREMS: Radiology in Emergency Medicine

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