Article Figures & Data
Figures
- FIG 1.
A 5-year-old girl with morning vomiting and headaches. A, Axial non-contrast-enhanced CT shows an oval homogeneous hyperdense mass lesion (arrow) located along the mesial left temporal lobe. B and C, Diffusion-weighted imaging and apparent diffusion coefficient map show no restricted diffusion (arrow) of the lesion. D and E, The lesion is nearly isointense (arrow) to gray matter on the T2-weighted and FLAIR imaging (F). The lesion shows avid homogeneous enhancement (arrow) on postcontrast T1-weighted imaging. The adjacent brain shows no edema. G, Follow-up sagittal postcontrast T1-weighted spine imaging after 6 months shows drop metastasis (arrow) with avid homogeneous enhancement.
- FIG 2.
An 18-year-old man with a recent presentation of a 2-day history of headache and vomiting. A, Coronal T2-weighted imaging shows a large mass lesion (arrow) in the pineal gland region. B, The lesion shows heterogeneous contrast enhancement (arrow) on coronal T1-weighted imaging, with mild restricted diffusion (arrow, C and D) on diffusion-weighted imaging and the matching apparent diffusion coefficient map.
- FIG 3.
An 8-year-old girl with no medical history available in the patient records. A and B, Axial CT images demonstrate a solid and cystic mass with solid portions isodense to normal brain parenchyma and scalloping (B, arrows) of the adjacent inner table of the parietal bone. C–F, MR images demonstrate a large right frontoparietal mass with extensive cystic/necrotic areas (C), surrounding edema (arrows, D), enhancement (E), and dural extension (arrows, F). The lesion causes mass effect and mild right-to-left midline shift.
- FIG 4.
A 3-year-old girl who presented with left-sided hemiparesis. A, Axial noncontrast CT image demonstrates multifocal masses (arrows) in the right cerebral hemisphere that are isodense to normal brain and associated with a large region of edema (asterisk). B–H, MR images demonstrate an infiltrative right cerebral hemisphere tumor (arrows) extending into the basal ganglia and thalamus, with subsequent mass effect, diffuse right cerebral hemispheric edema (asterisk), and right-to-left midline shift. Multifocal areas of contrast enhancement (arrows) are seen on axial and sagittal T1 weighted imaging with contrast (E and F). DWI and ADC map images demonstrate that the solid portion of the mass (arrows) is isointense to normal brain parenchyma (G and H).
- FIG 5.
A 5-year-old boy who presented with vision loss. A and B. Axial noncontrast CT images demonstrate a solid and cystic mass with dystrophic calcification (white arrow) and adjacent bone erosion (black arrow). C–F, MR images demonstrate a right frontal lobe tumor with cystic/necrotic areas, flow voids (C, arrowhead), surrounding edema, contrast enhancement of the tumor, dural extension, and focal areas of bone erosion (D–F, black arrow). There is notable intracranial mass effect, including a right-to-left midline shift.
Tables
MR imaging features of MEGNTs
All Temporal Pineal Extratemporal Mean maximum diameter (cm) 5.3 3.2 2.7 6.8 Cyst/necrosis (+) 80% 0% 100% 100% Flow voids (+) 60% 50% 0% 83% Perilesional edema (+) 80% 50% 50% 100% Calcification/hemorrhage (+) 50% 50% 50% 50% T1WI+C enhancement 100% 0% 50% 100% Leptomeningeal/dural extension (+) 50% 0% 0% 100% CSF distant metastases 30% 50% 50% 17% Mean ADC value (10–6 mm2/s) 737 795 1008 658 Note:—T1WI+C indicates T1 weighted imaging with contrast.
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