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Updated: Jan 5, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
[Benign and inflammatory lesions of the skull base]
1Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum des Saarlandes, Kirrbergerstraße 1, 66421, Homburg/Saar, Deutschland. m.wolska-krawczyk@uks.eu.
Abstract:
A variety of tumors, tumor-like non-neoplastic and inflammatory lesions occur in the skull base. A wide variety of diseases and lesions complicate the process of radiological diagnosis. The main task of imaging consists of the recognition and characterization of skull base lesions with detailed description of the extent of infiltration of adjacent structures, which is important for preoperative planning. Computed tomography (CT) and magnetic resonance imaging (MRI) are the preferred modalities for evaluating cranial base lesions. Above all, they depict more accurately the involvement of bones, vascular and nerve structures. MRI, especially T1-weighted sequences, provide superior contrast to CT soft tissue, which is useful for detecting lesions surrounded by high-fat bone marrow. T2-weighted MRI imaging is useful for characterizing watery tumor tissue/edema or cystic portions of the lesions. CT outperforms MRI in assessing the presence of calcification and osseous destruction. Knowledge of the clinical symptoms, as well as the overview of possible variants of the skull base lesions, aid in the diagnosis. The aim of this review is to present the most important benign and inflammatory lesions of the skull base as well as to investigate typical imaging phenomena of the most common lesions, and to provide insights into the most important anatomical landmarks of the skull base.
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