MR spectroscopy and diffusion MR imaging in characterization of common sellar and supra-sellar neoplastic lesions

Mohammad, Faten Fawzy; Hasan, Doaa Ibrahim; Ammar, Mohamed Gouda

doi:10.1016/j.ejrnm.2014.04.012

Cited by 9 publications

(11 citation statements)

References 14 publications

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“…A prominent lipid/lactate peak can sometimes be seen, despite the benign histology of the tumor. Elevation of myoinositol (mI) can also be detected, 5,11 with stable tumors showing higher mI peak. The decrease in mI is reported to foresee deterioration, even before clinical signs or radiological findings exist.…”

Section: Hypothalamic-chiasmatic Gliomamentioning

confidence: 99%

“…NAA decrease, elevation of choline, and moderate elevation of lipids is seen on MRS. 5 Iso-or hyperintensity can be seen on DWI, with mean ADC reported values ranging from 0.69 to 1.0 Â 10 À3 mm 2 /s. 5,16 Craniospinal irradiation or focal field irradiation combined with chemotherapy achieve high survival rates, 17,18 with a 10-year survival rate reported to be over 85%. 9 Radical tumor resection, in combination with radiotherapy and chemotherapy, is indicated in other germ-cell tumors of intermediate or poor prognosis.…”

Section: Germinomamentioning

confidence: 99%

“…3,4 On diffusion-weighted imaging (DWI) CRs are heterogeneously hypointense, with high apparent diffusion coefficient (ADC) values ([1.91 AE 0.2) Â 10 À3 mm 2 /s). 5 High viscosity fluid content can provide isointensity on DWI, with lower ADC values. 2 Spectroscopic findings of choline and lipid peaks differentiate CR from other pediatric suprasellar masses, 2,5 while the absence of any metabolite peak can also be seen in CRs.…”

mentioning

confidence: 99%

“…5 High viscosity fluid content can provide isointensity on DWI, with lower ADC values. 2 Spectroscopic findings of choline and lipid peaks differentiate CR from other pediatric suprasellar masses, 2,5 while the absence of any metabolite peak can also be seen in CRs. 5 Gross total surgical removal or partial removal with adjuvant radiotherapy achieves an excellent outcome in CR treatment.…”

mentioning

confidence: 99%

“…2 Spectroscopic findings of choline and lipid peaks differentiate CR from other pediatric suprasellar masses, 2,5 while the absence of any metabolite peak can also be seen in CRs. 5 Gross total surgical removal or partial removal with adjuvant radiotherapy achieves an excellent outcome in CR treatment. 6,7 Intracystic chemotherapy in cystic CRs is also reported to be associated with a good outcome.…”

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confidence: 99%

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Pediatric Sellar: Suprasellar Tumors

Papadopoulou

Chourmouzi

Drevelegas

2016

J Pediatr Neuroradiol

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Tumors of the sellar region are not infrequent in pediatric population and differ notably from the adult sellar tumors. Craniopharyngiomas represent almost half of sellar region tumors in children, followed by hypothalamic-chiasmatic gliomas, hypothalamic hamartomas, and germinomas. Other tumors or tumoral lesions are more infrequent. This article provides an overview of the imaging characteristics of pediatric sellar/suprasellar tumors on conventional magnetic resonance (MR) imaging that can orient the diagnosis or limit the differential diagnostic range. Furthermore, the physiologic characteristics assessed by advanced MR imaging techniques are also described in detail, providing a better preoperative characterization of pediatric sellar/suprasellar pathology.

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Section: Hypothalamic-chiasmatic Gliomamentioning

confidence: 99%

Section: Germinomamentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Pediatric Sellar: Suprasellar Tumors

Papadopoulou

Chourmouzi

Drevelegas

2016

J Pediatr Neuroradiol

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Tumors of the Sellar Region

Triulzi

2023

Neuroradiology of Brain Tumors

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Pituitary xanthogranulomas: clinical features, radiological appearances and post-operative outcomes

et al. 2018

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BackgroundXanthogranulomas are inflammatory masses most commonly found at peripheral sites such as the skin. Sellar and parasellar xanthogranulomas are rare and present a diagnostic challenge as they are difficult to differentiate from other sellar lesions such as craniopharyngiomas and Rathke’s cleft cysts pre-operatively. Their radiological imaging features are yet to be clearly defined, and clinical outcomes after surgery are also uncertain. This study reviews clinical presentation, radiological appearances, and clinical outcomes in a cohort of patients with pituitary xanthogranulomas.MethodsA prospectively maintained pituitary surgery database was screened for histologically confirmed pituitary xanthogranulomas between May 2011–December 2016. Retrospective case note assessments were then performed by three independent reviewers. Patient demographics, clinical presentations, imaging, and clinical outcomes were analysed.ResultsDuring the study period 295 endoscopic endonasal pituitary surgeries were performed. Six patients had confirmed pituitary xanthogranulomas (2%). Patients most commonly presented with visual field deficits and/or endocrine dysfunction. Common imaging features included: a cystic consistency, hyperintensity on T1-weighted MR images, and contrast enhancement either peripherally (n = 3) or homogenously (n = 3). The most common pre-operative endocrine deficits were hyperprolactinaemia and hypoadrenalism (at least one of which was identified in 4/6 patients; 66%). Thirty-three percent (2/6) of patients presented with diabetes insipidus. The most common post-operative endocrinological deficits were adrenocortical dysfunction (66%) and gonadotropin deficiency (66%). Visual assessments normalised in all six patients post-operatively. Gross total resection was achieved in all patients, and at median follow up of 33.5 months there were no cases of tumour recurrence.ConclusionsThe prevalence of pituitary xanthogranulomas in our series is higher than that suggested in the literature. Surgery restored normal vision to all cases, however four patients (67%) required long-term hormonal replacement post-operatively. Imaging features such peripheral rim enhancement, a suprasellar tumour epicentre, and the absence of both calcification or cavernous sinus invasion were identified as potential indicators that together should alert clinicians to the possibility of pituitary xanthogranuloma when assessing patients with cystic sellar and parasellar tumours.

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MR spectroscopy and diffusion MR imaging in characterization of common sellar and supra-sellar neoplastic lesions

Cited by 9 publications

References 14 publications

Pediatric Sellar: Suprasellar Tumors

Pediatric Sellar: Suprasellar Tumors

Tumors of the Sellar Region

Pituitary xanthogranulomas: clinical features, radiological appearances and post-operative outcomes

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