Type:
Educational Exhibit
Keywords:
Head and neck, Neuroradiology brain, CT, MR, Diagnostic procedure, Neoplasia
Authors:
A. I. Barrio Alonso1, J. Peña Suarez2, A. Cernuda GarcÃa3, P. A. RUEDA MEJIA3, A. Saiz3, E. Santamarta3, �. Meilán MartÃnez3; 1Gijón, Asturias/ES, 2Gijon/ES, 3Oviedo/ES
DOI:
10.26044/ecr2019/C-1637
Background
Solid brain lesions are more frequently hypodense,
with a lower percentage of spontaneous hyperdensity,
which gives this behavior a special value at the time of diagnosis.
The differential diagnosis of focal lesions of moderate-high density is narrow and relatively affordable by combining CT and MRI.
This mainly includes cavernoma,
certain metastases,
lymphoma and primary glial tumors highly cellular and,
therefore,
of high degree of malignancy.
We will emphasize that type of glial tumors given its high malignant potential and its relatively indolent aspect in the initial phases (subtle cortical hyperdensity,
little or no edema,
scarce or absent uptake).
Despite this aspect they tend to have a rapid and unfavorable evolution.
The most common clinical presentation is epileptic crisis.
Since the prognosis of high grade astrocytomas (AAG) is worse than the rest of lesions,
it is crucial to make a fast and correct differential diagnosis.
The characteristics in the CT,
together behavior in T1,
T2,
diffusion sequences and above all in MRI-perfusion,
will allow a very specific diagnosis so the realization of an early MRI is very important for the diagnosis and management suitable for patients.
We reviewed 21 patients with spontaneously hyperdense lesions on noncontrast CT,
its evolution and diagnosis in subsequent imaging studies.
We described the characteristics that are repeated in these gliomas and that have allowed a correct presurgical diagnosis in all cases.