Learning objectives
To understand the cause of hyperattenuation in various brain pathologies.
To list the differential diagnosis of hyperdense lesions with emphasis on uncommon lesions,
key imaging findings of each to arrive at the correct diagnosis.
Background
Hemorrhage is most common pathology which is hyperdense on plain CT of the brain.
There are various other causes of hyperdensity in the brain including hematoma or tumoralhemorrhage,
hypercellular lesions and intratumoral calcification.
Various neoplastic,
infective and vascular pathologies cause hyperdensity on CT.
MRI is the modality ofthe choice in evaluating brain pathologies,
it is essential to know the list of hyperdense lesions and its pathogenesis to narrow the differentials with better pathologicalperspective.
Hyperdense lesions on CT images are sometimes a clue or compliments MRI...
Findings and procedure details
Procedure details:
500 CT brain done between 2016 to 2018 were assessed.
22 different pathologies with hyperattenuation on non-contrast CT were identified.
The lesions were correlated with MRI and histopathology.
This exhibit reviews the various spectrum of hyperdense lesions with respective etiology.
The spectrum of hyperattenuating pathologies with likely etiology isas follows [1-4]:
1.
Neoplastic:
a.Intraxial:
Hypercellularity - Lymphoma,
Medulloblastoma,
Schwannoma.
Calcifications - Oligodendrogliomas.
Intratumoral hemorrhage - Metastasis,
GBM,
Melanocytoma.
b.
Intraventricular :
Hypercellularity - Meningioma.
Calcifications - Subependymal giant cell astrocytoma,
Ependymoma, Central neurocytoma....
Conclusion
In this pictorial essay,
we illustrate the imaging findings of various hyperdense intracranial pathologies with emphasis on uncommon lesions and key imaging findings to arrive at a correct diagnosis or narrow the differential diagnosis.
CT plays a complementary role in diagnosing various lesions along with MRI which is the imaging modality of choice in various cases.
References
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2.Osztie E,
Hanzély Z,
Afra D.
Lateral ventricle gliomas and centralneurocytomas in adults diagnosis and perspectives.
Eur J Radiol.
2009
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Epub 2007 Nov 19.
PubMed PMID: 18023315.
3.Fink KR,
Fink JR.
Imaging of brain metastases.
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4.Trivedi R,
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Magnetic resonance imaging...
