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MR imaging of primary tumors of trigeminal nerve and Meckel's cave
W T Yuh1, D C Wright, T J Barloon
1Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Abstract:
MR imaging features of 11 primary tumors of the trigeminal nerve and Meckel's cave were analyzed. The tumors consisted of two trigeminal schwannomas, five meningiomas, one lipoma, and three epidermoid tumors. The trigeminal schwannomas had homogeneously decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images. Three of the five meningiomas had signal intensity similar to that of surrounding brain on both T1- and T2-weighted images. One meningioma had decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images. The other had relatively low signal intensity on both T1- and T2-weighted images owing to heavy calcification demonstrated on CT. The lipoma had homogeneous signal intensity that was isointense with orbital and subcutaneous fat on both T1- and T2-weighted images. The epidermoid tumors had decreased signal intensity on T1-weighted images and markedly increased signal intensity on T2-weighted images. In addition, the epidermoids had an insinuating growth pattern and minimal mass effect. The extent of involvement in the trigeminal nerve distribution was well demonstrated in each case. Because of its multiplanar capability, exquisite anatomic detail, and characteristic tissue signal intensity, we conclude that MR is helpful in the differential diagnosis of primary tumors of the trigeminal nerve and Meckel's cave and in the evaluation of tumor involvement for preoperative planning.
Insights
Magnetic resonance imaging (MRI) effectively differentiates primary tumors of the trigeminal nerve and Meckel's cave. MRI reveals distinct imaging features for schwannomas, meningiomas, lipomas, and epidermoid tumors, aiding diagnosis.
Area of Science:
- Radiology
- Neuroimaging
- Oncology
Background:
- Primary tumors affecting the trigeminal nerve and Meckel's cave present diagnostic challenges.
- Accurate characterization of these tumors is crucial for effective treatment planning.
Purpose of the Study:
- To analyze and describe the magnetic resonance (MR) imaging features of primary tumors involving the trigeminal nerve and Meckel's cave.
- To evaluate the utility of MR imaging in the differential diagnosis and preoperative assessment of these tumors.
Main Methods:
- Retrospective analysis of MR imaging findings in 11 patients with primary tumors of the trigeminal nerve and Meckel's cave.
- Tumor types included trigeminal schwannomas, meningiomas, lipoma, and epidermoid tumors.
- Detailed evaluation of signal intensities on T1- and T2-weighted images, and assessment of tumor characteristics and extent.
Main Results:
- Trigeminal schwannomas showed decreased T1 and increased T2 signal intensity.
- Meningiomas displayed variable signal intensities, with some showing calcification on CT.
- Lipoma was isointense with fat, while epidermoid tumors had low T1 and markedly high T2 signal intensity with an insinuating growth pattern.
Conclusions:
- MR imaging provides detailed anatomical information and characteristic tissue signal intensities helpful in differentiating primary tumors of the trigeminal nerve and Meckel's cave.
- The multiplanar capabilities of MR imaging are valuable for assessing tumor involvement and aiding preoperative planning.