Hemorrhagic intracranial malignant neoplasms: spin-echo MR imaging.

Abstract

Twelve patients with 15 separate, spontaneously hemorrhagic, intracranial malignant lesions (seven primary gliomas, eight metastatic lesions) were examined with spin-echo magnetic resonance imaging at 1.5 T, and with computed tomography. The signal intensity patterns of these lesions, as seen on both short repetition time (TR)/short echo time (TE) and long-TR/long-TE spin-echo pulse sequences, were compared with the previously described appearance at 1.5 T of non-neoplastic intracerebral hematomas. The images of hemorrhagic intracranial malignancies showed notable signal heterogeneity, often with identifiable nonhemorrhagic tissue corresponding to tumor; diminished, irregular, or absent hemosiderin deposition; delayed hematoma evolution; and pronounced or persistent edema, compared with non-neoplastic hematomas. The demonstration of these characteristics in the appropriate clinical setting may suggest malignancy as the cause of an intracranial hematoma.

Hemorrhagic cerebral metastasis as a first manifestation of a hepatocellular carcinoma: case report

“…For metastatic intracranial tumors, bronchogenic carcinoma, choriocarcinoma, malignant melanoma, renal cell carcinoma, thyroid carcinoma, germinoma and prostatic adenocarcinoma are the most common histologic types. Hemorrhage into malignant neoplasms accounts for 10% of all spontaneous intracranial hematomas 4 , and 5 to 10% of patients with cerebral metastasis may present with acute neurologic symptoms caused by hemorrhage into the tumor or cerebral infarction 5 .…”

Discrimination of Tumorous Intracerebral Hemorrhage from Benign Causes Using CT Densitometry

“…Exclusion criteria consisted of intraventricular hemorrhage or SAH as a main component of intracranial hemorrhage (n ϭ 39), traumatic ICH (n ϭ 83), or hemorrhagic transformation of acute infarction (n ϭ 12), and patients with definitive tumorous ICH with gross cystic or solid portions (n ϭ 14) or multiple hemorrhagic lesions (n ϭ 12). 9,15 Additionally, we also excluded cases of uncertain-cause ICH in patients who were either not sufficiently followed up with imaging or whose condition was not pathologically proved and could not be retrospectively classified as tumorous or nontumorous ICH (n ϭ 13). Patients with initial outpatient NECT images of inadequate image quality were also excluded (n ϭ 6).…”

“…Because most patients with ICH with tumors have a solid enhancing portion, contrast-enhanced CT or contrast-enhanced MR imaging are indicated when secondary ICH with tumor is suspected. [8][9][10] However, enhancement of secondary ICH can be obscured by surrounding high attenuation or various T1 signal intensities from hematoma; these make diagnosis of secondary ICH difficult. [10][11][12] Dual-energy CT offers better differentiation between ICH of tumor and nontumor etiology because of better visualization of the enhancing lesion within a high-attenuation hemorrhage.…”

Imaging features of primary and metastatic alveolar soft part sarcoma: single institute experience in 25 patients

“…The PET/CT images were reviewed on a HERMES GOLD TM (Hermes Medical Solutions Inc., Greenville, NC) workstation. The MRI examinations were performed on a 1.5-T MRI (GE Healthcare) or 3-T MRI (Siemens Medical Solutions) scanner with gadolinium administration at doses of 0.1 mmol kg 21 body weight up to a maximum dose of 20 ml. Primary tumour locations were grouped into "torso" (including the pelvic and shoulder girdles), "extremity" and "head-face-neck".…”