Learning objectives
The objectives of this educational poster are to illustrate the principal imaging findings of central nervous system (CNS) ependymomas,
exhibiting the spectrum of presentation,
as well as some complications of the tumor.
Background
They can occur anywhere within the neuraxis.
The great majority of ependymomas are infratentorial (up to 70%),
followed by supratentorial and lastly spinal cord.
These compartments subgroups present different gender and age predilection.
Clinical symptoms vary with location,
manifesting with headache,
focal neurological deficit and seizures in supratentorial ependymomas and hydrocephalus with increased intracranial pressure when intraventricular.
Pain,
weakness and sensory symptoms are present in spinal ependymomas.
Magnetic resonance imaging (MRI) is the primary imaging modality used for the assessment of both intracranial and spinal...
Findings and procedure details
In our study,
we evaluated a great number of ependymoma cases,
with initial complain of CNS masses,
confirmed by anatomopathological studies.
Although the main imaging test for evaluation of central nervous system tumors is magnetic resonance with contrast,
in the beginning of the symptoms many patients undergo cranial CT,
mainly due to accessibility.
General features (Table 1):
Ependymomas are heterogeneous expansive massesthat generally have the same imaging characteristics at CT and MRI.
The solid component of the lesions is iso/hypoattenuating to surrounding normal brain tissue...
Conclusion
Ependymomas are one of the most common neoplasms of the CNS in both children and adults.
Therefore,
it is extremely important the knowledge of main radiological manifestations and anatomical relationships of these tumors,
especially for non-specialists radiologists and residents of the area,
providing the suspicion of this diagnostic and proper routing.
It is also essential examination of all neuraxis in affected patients,
owing to most preoperative prognostic factor to be the spread through cerebrospinal fluid.
Personal information
Dr.
Marcelo Ricardo Canuto Natal
Neuroradiology Section.
Department of Radiology,
Instituto Hospital de Base do Distrito Federal.
SMHS – Área Especial – Quadra 101 - Asa Sul,
Brasília - DF,
70330-150.
Head of Imaging Department of Sabin Medicina Diagnóstica.
SCN 01 – Quadra 01 – Bloco D – Asa Norte,
Brasília – DF,
70711-040.
E-mail:
[email protected]
Dr.
Cassio Lemos Jovem
Neuroradiology Section.
Department of Radiology,
Instituto Hospital de Base do Distrito Federal.
SMHS – Área Especial – Quadra 101 - Asa Sul,
Brasília - DF,...
References
1.Yuh EL,
Barkovich AJ,
Gupta N.
Imaging of ependymomas: MRI and CT.
Childs Nerv Syst.
2009;25(10):1203-13.
2.Mermuys K,
Jeuris W,
Vanhoenacker PK,
Van Hoe L,
D’Haenens P.
Bestcasesfrom theAFIP:supratentorialependymoma.
Radiographics.
2005;25(2):486-90.
3.Koeller KK,
Sandberg GD,
Armed Forces Institute of Pathology.
From the Archives of the AFIP Cerebral Intraventricular Neoplasms: Radiologic-Pathologic Correlation.
Radiographics.
2002; 22(6):1473-505.
4.
Koeller KK,
Rosenblum RS,
Morrison AL.
Neoplasmsof thespinalcordandfilumterminale:radiologic-pathologiccorrelation.
Radiographics.
2000; 20(6):1721-49.
5.
Louis DN,
Ohgaki H,
Wiestler OD,
Cavenee WK.
WHO Classification of Tumours of the Central Nervous System.
4th...