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Supratentorial ependymoma: CT appearance.

W G Armington, A G Osborn, D A Cubberley

    Radiology
    |November 1, 1985
    PubMed
    Summary
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    Computed tomography (CT) reveals supratentorial ependymomas are typically large, cystic, and intraparenchymal tumors. Malignant variants show distinct CT features compared to cellular types.

    Area of Science:

    • Neuroradiology
    • Neuro-oncology
    • Pathology

    Background:

    • Ependymomas are glial tumors arising from ependymal cells.
    • Supratentorial ependymomas represent a subset with distinct clinical and radiological characteristics.
    • Accurate preoperative diagnosis is crucial for treatment planning.

    Purpose of the Study:

    • To analyze the computed tomographic (CT) imaging features of biopsy-proven supratentorial ependymomas.
    • To differentiate between cellular ependymomas and their malignant counterparts (malignant ependymomas and ependymoblastomas) based on CT findings.

    Main Methods:

    • Retrospective analysis of CT scans from 22 patients with biopsy-proven supratentorial ependymomas.
    • Evaluation of tumor size, location, cystic components, contrast enhancement patterns, calcification, hydrocephalus, peritumoral edema, and attenuation values.

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    Main Results:

    • Supratentorial ependymomas were predominantly intraparenchymal, larger than 4 cm, and cystic.
    • Moderate to intense, homogeneous or ring-like contrast enhancement was common; calcification was seen in one-third of cases.
    • Malignant ependymomas and ependymoblastomas exhibited higher pre-contrast attenuation, more intense enhancement, less calcification, and less distinct margins compared to cellular ependymomas.

    Conclusions:

    • CT imaging can characterize supratentorial ependymomas, identifying key features like size, cystic nature, and enhancement patterns.
    • Distinct CT findings, including pre-contrast attenuation and enhancement intensity, may help differentiate malignant ependymomas from cellular types, aiding in diagnosis and management.