Supratentorial primary intra-axial tumors in children. MR and CT evaluation.
OBJECTIVE
To evaluate the MR and CT features of pediatric supratentorial intra-axial tumors with respect to differential diagnosis and the role of each investigation modality.


METHODS
MR and CT findings in 40 children with 12 types of pathologically proven histological tumors were reviewed.


RESULTS
The location of tumors might be one clue to differential diagnosis. In our material, cysts (60%), calcifications (45%), and intratumoral hemorrhages (27%) were found in the tumors. Characteristic features noted in some lesions included: peritumoral hemosiderin deposition in cavernous angiomas; intratumoral flow void in a choroid plexus carcinoma and in glioblastomas; and hemicerebral atrophy in germinomas. A comparison between malignant and benign tumors showed perifocal edema and a mass effect to be significantly more common in malignant lesions. Homogeneous enhancement suggested a benign tumor and an inhomogeneous pattern represented malignancy, while the lack of obvious enhancement did not always suggest benignity. Intratumoral calcium deposition was a not uncommon finding in malignant tumors.


CONCLUSIONS
In most cases, the exact diagnosis should be made by histological examination but it is important for treatment planning that the appropriate depiction of tumor extension and tissue characterization be made by MR and CT.
Higano
S
S
Department of Radiology, Tohoku University School of Medicine, Sendai, Japan.
Takahashi
S
S
Kurihara
N
N
Ishii
K
K
Matsumoto
K
K
Shirane
R
R
Katakura
R
R
Singh
L N
LN
Yamada
S
S
D000293:Adolescent; D001284:Atrophy; D001929:Brain Edema / Q000175:diagnosis / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D002118:Calcium / Q000378:metabolism; D002277:Carcinoma / Q000098:blood supply / Q000175:diagnosis / Q000000981:diagnostic imaging; D002526:Cerebellar Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D016545:Choroid Plexus Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000000981:diagnostic imaging; D003560:Cysts / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D018237:Germinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D005909:Glioblastoma / Q000098:blood supply / Q000175:diagnosis / Q000000981:diagnostic imaging; D006392:Hemangioma, Cavernous / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D006485:Hemosiderin / Q000032:analysis; D006801:Humans; D007089:Image Enhancement; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011856:Radiographic Image Enhancement; D015173:Supratentorial Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
D006485:Hemosiderin; D002118:Calcium