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Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

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Central Skull Base Neoplasms.

Xin Cynthia Wu¹

¹Division of Neuroradiology, Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.

Radiologic Clinics of North America

|November 13, 2025

Summary

Evaluating central skull base neoplasms is complex due to anatomical challenges and mimics. This review guides radiologists through differentials and imaging features of common central skull base tumors.

Keywords:

Central skull base Chondrosarcoma Chordoma Meningioma Osteosarcoma PitNET Schwannoma

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Area of Science:

Radiology
Oncology
Neuroimaging

Background:

The central skull base is an anatomically complex region prone to neoplasms.
Differentiating neoplastic from nonneoplastic pathologies is challenging.
Percutaneous biopsy is difficult, and sensitive neurovascular structures are present.

Purpose of the Study:

To review central skull base anatomy.
To provide an anatomically oriented approach to mass differentials.
To illustrate imaging features of common central skull base neoplasms.

Main Methods:

Anatomical review of the central skull base.
Differential diagnosis framework based on anatomical location.
Illustration of imaging findings for common neoplasms.

Main Results:

Anatomical organization aids in differential diagnosis of central skull base masses.
Specific imaging features help identify common neoplasms.
Understanding anatomy is crucial for accurate radiologic evaluation.

Conclusions:

Anatomically oriented approach simplifies central skull base mass evaluation.
Radiologists can improve diagnostic accuracy with knowledge of anatomy and imaging features.
This review provides a practical guide for diagnosing central skull base neoplasms.