Transcranial ultrasonography imaging of a suprasellar meningioma: A case description and technical notes

Abstract

Background Computed tomography (CT) and magnetic resonance (MR) represent the gold standard for evaluating intracranial tumours, such as meningiomas; most meningiomas can be managed by surveillance and clinical follow‐up, therefore, the ideal technology should be cheap, non‐invasive, safe and able to reduce radiation exposure. Transcranial colour‐coded duplex sonography (TCCS) can detect space‐occupying lesions, but its full potential for clinical practice is still unexpressed. Aims and Methods We describe the ability of TCCS to directly and accurately image, in a 77‐year‐old woman hospitalised for septic shock and coma, a suprasellar meningioma with a spatial resolution very similar to CT. Results The meningioma was clearly visualised as a roundish mass, with well‐defined borders, heterogeneously hyperechogenic compared with the surrounding brain structures; multiple intralesional calcifications were detectable as highly echogenic spots. Latero‐lateral and antero‐posterior diameters were well measurable. Discussion TCCS should not be considered as an alternative to CT and MR imaging, but it might have a complementary role, useful for use at the bedside in uncooperative or non‐transportable patients and for follow‐up, when an adequate acoustic window is guaranteed. Neurologists and neuroradiologists should further explore the full potential of this technology.