Type:
Educational Exhibit
Keywords:
Education and training, Diagnostic procedure, MR, CT, CNS
Authors:
T. Oliveira1, M. C. Calegari2, R. O. Martins2, F. Melo1, C. L. Jovem2, M. A. Leão1, M. Natal1; 1Brasilia/BR, 2Brasília, DF/BR
DOI:
10.26044/ecr2019/C-3085
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 ependymoma.
Although small calcifications within tumors are better demonstrated by computed tomography (CT),
MRI provides superior delineation of the extent of tumor due to its greater soft tissue contrast,
multiplanar imaging capability and ability to obtain complementary information with T1 and T2 weighted images (WI) sequences.The treatment of choice is total radical resection.
The main preoperative prognostic factor for all patients is the spread through the cerebrospinal fluid,
being important the examination of all neuraxis after the diagnosis.
The prognosis is relatively poor,
mainly due to surgically challenging locations of the tumors,
making complete resection difficult.
Then,
postoperative imaging is considered crucial in documenting the presence of residual disease,
which has a substantial negative impact on survival rates.