Author:
Jeremy Horn
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NECT |
CECT |
MRI - T1 |
MRI - T2 |
MRI - FLAIR |
MRI - Diffusion/ADC |
MRI - T1 post-contrast |
Additional Comments |
Meningioma |
Hyperattenuated intraventricular mass +/- calcifications
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Intense enhancement (no image available).
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Iso- to hypointense
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Iso- to hyperintense
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Hyperintense with peritumoral edema
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Variable (no image shown)
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Intense enhancement
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Metastasis |
Variable appearance depending on primary malignancy; here seen as a hyperattenuating mass in a woman with intraventricular melanoma
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Usually enhances, as seen in this case of intraventricular melanoma
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Heterogeneous; hyperintensity may be seen from hemorrhage
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Heterogeneous depending on primary malignancy
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Intense enhancement
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Renal and lung most common primaries
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Lymphoma |
Usually hyperdense; may have hypointense rim of edema
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Moderate uniform enhancement; occasionally see ring enhancement
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Iso- to hypo-intense to the cortex
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May show restricted diffussion
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Homogenous enhancement; can see peripheral enhancement in immunocompromised or with central necrosis
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Ependymoma |
Usually isoattenuating within or adjacent to the ventricles; heterogeneous and may contain calcifications
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Heterogeneous, usually iso- to hypo-intense (+/- calcifications, cysts, hemorrhage)
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Heterogeneous, usually iso- to hyper-intense
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Hyperintense; sharp contrast with CSF
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Variable (no image)
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Moderate heterogeneous enhancement
Image 2
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2/3 infratentorial, within 4th ventricle (often causing hydrocephalus); 1/3 supratentorial in lateral ventricle or periventricular parenchyma. Most common in children.
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Subependymoma |
Iso- to hypodense intraventricular mass +/- calcifications
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Usually little to no enhancement (no image available)
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Heterogeneous intraventricular mass, hypo- to iso-intense to white matter
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Heterogeneous hyperintense intraventricular mass
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Hyperintense intraventricular mass
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Usually little to no enhancement
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Rare well-differentiated intraventricular tumor, most commonly arising within fourth ventricle. Extraventricular extension and recurrence both extremely rare.
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Choroid
Plexus Papilloma/Carcinoma |
Lobular intraventricular mass, usually iso- to hyperdense +/- calcifications, often with associated hydrocephalus. Seen here in the fourth ventricle at the foramen magnum
Image 2
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Intensely enhancing (no image)
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Lobulated, intraventricular mass
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Iso- to hyperintense intraventricular mass, usually causing hydrocephalus
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Hyperintense intraventricular mass
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Intense, near homogenous enhancement
Image 2
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50% of patient <10 y for lateral ventricle tumors. Fourth ventricular lesions seen in patients 0–50 y. Papilloma difficult to distinguish from carcinoma radiograhpically. MR spectography shows absent NAA, mildly increased choline.
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Colloid
Cyst |
Located at the foramen of Monro, usually hyperdense (70%)
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Usually no enhancement (no image available)
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Depends on cholesterol content; 2/3 hyperintense, remainder are isointense; +- hydrocephalus
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Variable signal depending on water content; usually isointense
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No suppression on FLAIR imaging
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No diffusion restriction
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Usually no enhancement; rarely see rim enhancement
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Characteristically occur at the anterosuperior aspect of the third ventricle and may obstruct the adjacent foramen of Monro.
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Subependymal Giant Cell Astrocytoma |
Hypo- to isodense mass near the foramen of Monro +/- calcifications; may see other signs of tuberous sclerosis (including calcified subependymal nodules)
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Strong heterogeneous enhancement (no image shown)
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Hypointense +/- calcification
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Iso- to hyperintense compared to surrounding white matter
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Strong enhancement
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Seen in children with tuberous sclerosis. All lesions in lateral ventricle near foramen of Monro, with occasional extension into third ventricle.
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Central
Neurocytoma |
Mixed solid and cystic mass, most frequently within the frontal horn/body of lateral ventricle, often with calcifications
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Heterogeneous enhancement
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Heterogeneous, isointense to gray matter
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Heterogeneous, iso- to hyper-intense, with hyperintense cystic regions
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Heterogeneous, predominantly hyperintense
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Not defined in the literature; this image demonstrates a large central neurocytoma causing restricted diffusion, confirmed on the ADC map
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Heterogeneous enhancement, greater than the surrounding brain parenchyma
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20-40 y most common. Usually arises in lateral ventricles from the septum pellucidum; occassionally extends into third ventricle.
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Neurocysticercosis |
May see thin wall of cyst within the ventricles; cyst can cause hydrocephalus
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Most helpful sequence to detect intraventricular cysts. Intensity depends on stage; here see a hyperintense scolex casuing dilatation of the fourth ventricle.
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Cyst usually hyperintense but masked by hyperintense CSF
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Intraventricular cysts less common than cysts located in the subarachnoid space, cisterns, and parenchyma. When intraventricular, cysts are often isolated and can cause obstructive hydrocephalus.
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