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Chordomas of the skull base: dynamic MRI
I Ikushima1, Y Korogi, T Hirai
1Department of Radiology, Kumamoto University School of Medicine, Japan.
Objective:
To investigate the role of dynamic MRI in the diagnosis of chordomas at the skull base.
Materials And Methods:
Six patients with surgically proven chordomas of the skull base were examined with spin-echo technique (repetition time/echo time 200 ms/15 ms). Serial imaging was performed every 30 s for 240 s after a rapid injection of gadopenetate dimeglumine (0.1 mmol/kg). The contrast material enhancement ratio (CER) was analyzed. The CER was obtained for each region of interest as follows (Sn - So) x 100/Smax - So, where Sn indicates signal intensity at each dynamic phase; So, signal intensity on the image obtained before administration of contrast material; and Smax, maximum signal intensity of all dynamic imaging.
Results:
All chordomas showed very slow but steady increase of contrast enhancement with no peak within 240 s. The CERs of six cases at 30 s are 13 to 40 (mean value +/- standard deviation: 22.8 +/- 10.2).
Conclusion:
Dynamic MRI may be helpful in differentiating between chordomas and other tumors of the skull base.
Insights
Dynamic MRI aids in diagnosing skull base chordomas by showing a slow, steady contrast enhancement over 240 seconds. This characteristic pattern helps differentiate chordomas from other tumors.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Skull base chordomas are rare bone tumors.
- Accurate diagnosis is crucial for treatment planning.
Purpose of the Study:
- To evaluate the utility of dynamic MRI in diagnosing skull base chordomas.
- To characterize the enhancement patterns of chordomas using dynamic MRI.
Main Methods:
- Six patients with skull base chordomas underwent dynamic MRI with gadolinium contrast.
- Spin-echo technique was used with serial imaging every 30 seconds for 240 seconds.
- Contrast Enhancement Ratio (CER) was calculated to quantify enhancement.
Main Results:
- All chordomas exhibited a slow, continuous increase in contrast enhancement without reaching a peak within 240 seconds.
- The mean CER at 30 seconds was 22.8 +/- 10.2.
Conclusions:
- Dynamic MRI's characteristic slow enhancement pattern may help differentiate skull base chordomas from other tumors.
- This technique offers a potential non-invasive diagnostic tool for skull base lesions.