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Intracerebral metastases MRI

Introduction

Overview

Overview

Brain MRI is helpful in the diagnosis of intracerebral metastases. On MRI, intracerebral metastases are characterized by iso- to hypointensity on T1-weighted imaging and hyperintense portion on T2-weighted imaging. On contrast administration, intense enhancement is observed (uniform, punctate, or ring-enhancing). Peritumoral edema which is out of proportion with tumor size is observed on diffusion weighted imaging.[1]

MRI

MRI

  • On MRI, brain metastases are typically found in the watershed areas of the brain (areas where blood vessels narrow and act as a trap for clumps of tumor cells).[2]
  • Findings on MRI suggestive of intracerebral metastases are tabulated below:[1]
MRI component Findings

T1

  • Typically iso- to hypointense
  • If hemorrhagic, may have intrinsic high signal
  • Non-hemorrhagic melanoma metastases can also have intrinsic high signal due to the paramagnetic properties of melanin

T1 with contrast

  • Enhancement pattern can be uniform, punctate, or ring-enhancing, but it is usually intense
  • Delayed sequences may show additional lesions, therefore contrast-enhanced MRI is the current standard for small metastases detection

T2

  • Typically hyperintense
  • Hemorrhage may alter this (hypointense)

FLAIR

  • Typically hyperintense with hyperintense peri-tumoral edema

Diffusion weighted imaging (DWI)

  • Edema is out of proportion with tumor size and appears dark on trace-weighted DWI
Gallery
References

References

  1. ↑ 1.0 1.1 Radiographic MRI features of brain metastasis. Bruno Di Muzio and Dr Trent Orton et al. Radiopaedia 2015. http://radiopaedia.org/articles/brain-metastases
  2. ↑ Khuntia, Deepak (2015). “Contemporary Review of the Management of Brain Metastasis with Radiation”. Advances in Neuroscience. 2015: 1–13. doi:10.1155/2015/372856. ISSN 2356-6787.
  3. ↑ MRI image of brain metastasis. Wikipedia 2015. https://en.wikipedia.org/wiki/Brain_metastasis. Accessed on November 9, 2015
  4. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
  5. ↑ Image courtesy of Dr. Laughlin Dawes. Radiopaedia (original file here). Creative Commons BY-SA-NC
  6. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
  7. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
  8. ↑ Image courtesy of Dr. Paresh K Desai. Radiopaedia (original file here). Creative Commons BY-SA-NC
  9. ↑ Image courtesy of Dr. Roberto Schubert. Radiopaedia (original file here). Creative Commons BY-SA-NC
  10. ↑ Image courtesy of Dr. M Shebl. Radiopaedia (original file here). Creative Commons BY-SA-NC
  11. ↑ Image courtesy of Dr. Ahmed Abd Rabou. Radiopaedia (original file here). Creative Commons BY-SA-NC
  12. ↑ Image courtesy of Dr. Ahmed Abd Rabou. Radiopaedia (original file here). Creative Commons BY-SA-NC


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]