Cerebellopontine Angle Masses : A Visionary Approach

Congress:

ECR 2019

Poster Number:

C-3274

Type:

Educational Exhibit

Keywords:

Oncology, MR, Imaging sequences, Neoplasia

Authors:

S. Kadri¹, S. Arooj², A. Ghulam Mohammad ², N. Ahmed², F. ahmad³, T. Mahmood²; ¹Karachi, karachi/PK, ²Karachi/PK, ³Lahore/PK

DOI:

10.26044/ecr2019/C-3274

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3274

Fig. 1: Right Acoustic neuroma: 48 year old female with progressive hearing loss...

Fig. 2: Meningioma : 41 year old female having left extra axial. dural based enhancing...

Fig. 3: Arachnoid cyst: T2WI,Flair AND DWI images showing a well-defined cerebrospinal...

Fig. 5: AVM at left CP angle

Learning objectives

To study common Cerebellopontine angle masses and their imaging features To study current MRI imaging techniques to differentiate them from each other

Background

Cerebellopontine angle is a space filled with cerebrospinal fluid. The lateral border, formed by the petrous temporal bone. Medially it is continuous with the pontine and medullary cisterns, and pons itself. The posterior border is formed by the cerebellar hemisphere. The CPA roof is limited by the tentorium and its attachment to the petrous bone. The fifth through eighth cranial nerves are in the upper part of the CPA cistern, and the lower portion contains the 9th, 10th, and 11th cranial nerves. Cerebellopontine angle (CPA)...

Findings and procedure details

Acoustic neuromas and meningiomas represent the great majority of CP angle. The tumors usually arise from the cerebellopontine cistern and other structures like arachnoid cyst, schwannoma, aneurysm/ AVM,other meningeal lesions or from embryologic remnants like epidermoid cyst, dermoid cyst, lipoma. Tumors can also invade the CPA by extension from the petrous bone or skull base in paraganglioma, chondromatous tumors and chordoma.the other differential ofCPA lesions can be secondary to an exophytic brainstem or ventricular tumor like metastasis, glioma, choroid plexus papilloma,lymphoma,hemangioblastoma, ependymoma, medulloblastoma. MRI, 1.5...

Conclusion

A sound knowledge of the anatomy, with proper MRI examination protocol is important in establishing the diagnosis of the CP angle masses. The Radiologist has a vital role in distinguishing these lesions with different origins.

Personal information

Dr. Shazia Kadri Consultant Radiologist Cyberknife Robotic radiosurgery / Radiology dept JPMC Karachi E mail: [email protected]

References

Dhakshina Ganeshan, Deepa Anand, Radiological Reasoning: Cerebellopontine Mass causing Hemifacial spasm, 2010,AJR:195. Lipper MH, Goldstein JM. Neurosarcoidosis mimicking a cerebellopontine angle meningioma. AJR Am J Roentgenol 1998; 171:275–276. Anne Osborn, Susan Blaser, Karen Salzman, Diagnostic Imaging: Brain,2004, AMIRSYS Tali ET, Yuh WT, Nguyen HD et al. Cystic acoustic schwannomas:MR characteristics. AJNR Am J Neuroradiol.14(5):1241-7 Moffat DA, Ballagh RH. Rare tumours of the cerebellopontine angle. Clin Oncol 1995; 7:28–41.