Optic tract edema: a highly specific magnetic resonance imaging finding for the diagnosis of craniopharyngiomas.
OBJECTIVE
To clarify the accuracy, sensitivity, and specificity of optic tract edema in the diagnosis of craniopharyngiomas.


METHODS
Preoperative magnetic resonance images (MRIs) of 49 patients (between May 1996 and March 2003) who had a diagnosis of parasellar masses were blindly reviewed by two radiologists. The spread of edema surrounding the tumor on the coronal TSE T2-weighted images was analyzed. Sensitivity and specificity were calculated based on the numbers in this series and also pooled numbers from previous known reported series.


RESULTS
Edema along the optic tracts was detected in 7 of 11 craniopharyngiomas, giving a sensitivity of 63.6% (95% CI = 30.8-89.1) for our series and 66.7% (95% CI = 47.2-82.7) for the pooled numbers. The specificity was 100% (95% CI = 90.7-100.0) for our series and 93.9% (95% CI = 87.1-97.7) for the pooled numbers. None of the 28 pituitary macroadenomas, 4 meningiomas, 2 hypothalamic astrocytomas, 2 germinomas, 1 mixed-germ cell tumor and 1 arachnoid cyst in our study showed edema of the optic pathways.


CONCLUSIONS
Optic tract edema, commonly seen in craniopharyngiomas, is a useful MR finding for distinguishing craniopharyngiomas from other parasellar tumors with considerable sensitivity and high specificity.
Hirunpat
S
S
Department of Radiology and Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. hirsirip@medicine.psu.ac.th
Tanomkiat
W
W
Sriprung
H
H
Chetpaophan
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014795:Visual Pathways / Q000473:pathology*