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MR of vascular encasement in parasellar masses: comparison with angiography and CT
S C Young1, R I Grossman, H I Goldberg
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Abstract:
The relationship between tumor mass and vascular involvement as seen on MR imaging was examined in 11 patients with masses in the parasellar region, and the findings were correlated with CT and angiography. In six cases, MR was superior to CT and angiography in depicting the relationship of the tumor to adjacent blood vessels. In these cases, MR demonstrated tumor surrounding the blood vessel without changing the diameter of its lumen. Angiography did not reveal encasement in these cases. In four cases, both MR and angiography showed signs of vascular encasement with narrowing of the vessel's lumen. In two cases, MR was equivocal while angiography revealed vascular encasement in one case and was negative for encasement in the other. CT was less sensitive than MR in defining vascular encasement since there is usually little contrast between an enhancing tumor and the major blood vessels. Coronal scanning appeared to be the best plane of imaging and correlated well with the anteroposterior angiogram. We propose that MR is the method of choice for evaluating arterial encasement by tumors and may obviate the need for angiography in those cases in which MR is positive for a basal lesion.
Insights
Magnetic Resonance (MR) imaging is superior to CT and angiography for assessing tumor vascular involvement in the parasellar region. MR imaging can accurately detect arterial encasement by tumors, potentially reducing the need for angiography.
Area of Science:
- Radiology
- Oncology
- Neuroimaging
Background:
- Parasellar region tumors present diagnostic challenges.
- Accurate assessment of vascular involvement is crucial for treatment planning.
Purpose of the Study:
- To evaluate the efficacy of MR imaging in assessing tumor vascular involvement compared to CT and angiography.
- To determine if MR imaging can replace conventional angiography for evaluating arterial encasement by parasellar tumors.
Main Methods:
- Retrospective analysis of 11 patients with parasellar masses.
- Correlation of MR imaging findings with CT and angiography.
- Evaluation of tumor-vessel relationship, including encasement and lumen diameter changes.
Main Results:
- MR imaging was superior to CT and angiography in 6/11 cases, accurately showing tumor surrounding vessels without lumen narrowing.
- Both MR and angiography showed vascular encasement in 4/11 cases.
- CT demonstrated lower sensitivity in defining vascular encasement compared to MR.
Conclusions:
- MR imaging is the preferred method for evaluating arterial encasement by parasellar tumors.
- MR imaging may obviate the need for angiography in cases of suspected arterial encasement.
- Coronal MR imaging planes correlate well with anteroposterior angiograms.