Aims and objectives
Intracranial metastases represent the most central common nervous system neoplasm [1] and have a poor prognosis [2].
Most of them are solitary parenchymal lesions (Fig.
1,
2) (80 % located in the cerebral hemispheres,
15 % in the cerebellum,
3 % in the basal ganglia,
while the brainstem is a rare localization).
[3] Uncommon localisations for intracranial metastases are: leptomeningeal (found in only 5 % of patients with systemic neoplasms),
ventricular (accounting for 1-5 % of cerebral metastases,
most commonly in the lateral ventricle choroid...
Methods and materials
58 patients with intracranial metastases,
aged between 37 and 86 (mean of 65,13),
were examined between 1st January 2015 and 31st December 2016.
The CT examinations were performed using a 64-row multidetector machine and the MRI exams with a 1.5 T device,
both from the same manufacturer.
Head non-enhanced and contrast-enhanced protocols were used.
Standard MRI sequences included sagittal T1,
axial T2,
Flair,
diffusion-weighted imaging (DWI),
Apparent Diffusion Coeficient (ADC) and 3D fat-saturated T1 post-Gadolinium injection.
Axial T2*,
coronal or 3D Flair,
small FOV coronal...
Results
12 patients (21 %) presentedunique parenchymal metastases and 13 patients (22 %) only intracranial metastases.
We noticed a slight female predominance (30 females – 52 % versus 28 men – 48 %).
The primary neoplasms proved to be: pulmonary (40 %),
breast (21 %),
digestive (14 %),
genital (5 %),
melanoma (3 %),
neuroendocrine (3 %),
urothelial (3 %),
bone (2 %) and unknown in 9 %.
The most common primary cancers responsible for intracranial metastases are lung,
breast and melanoma,
but 10 % remain...
Conclusion
In our study,
metastases were identified in adults from their 4th to their 9th decade of life.
Most of the patients presented multiple cerebral lesions.
We confirm pulmonary (Fig.
11) and breast cancer as the most prequent primary malignancies,
while melanoma was discovered in only 3 % of cases.
In a relatively short period of time we also identified rare (brainstem and basal ganglia) (Fig.
12) and uncommon (meningeal,
orbital,
intraventricular,
pituitary and sinonasal ) localisations for metastases.
Intracranial secondary lesions have indeed various localisations...
Personal information
G-D Andron,
Radiology Resident
"Gr.
T.
Popa" University of Medecine and Pharmacy,
Iaşi,
Romania
Emergency Hospital "Professor Doctor Nicolae Oblu",
Iaşi,
Romania
Centre Hospitalier de Roanne,
France
Phone: +33683611700
e-mail:
[email protected]
References
Grand S,
Pasteris C,
Attye A,
Le Bas J-F,
Krainik A (2014) Les différents visages des métastases du système nerveux central.
Journal de Radiologie Diagnostique et Interventionnelle.
95,
908-922.
Hall WA,
Djalilian HR,
Nussbaum ES,
Cho KH (2000) Long-term survival with metastatic cancer to the brain.
Medical Oncology.
17,
279-286.
Osborn AG,
Blaser SI,
Salzman KL et al.
(2004) Diagnostic Imaging.
Brain.
Utah: Amirsys Inc.
Osborn AG (2013) Osborn's brain: imaging,
pathology,
and anatomy.
Manitoba: Amirsys Inc.
Raghavan P,
Mukherjee S,
Jameson M,
Wintermark M...