UMEM Educational Pearls

Category: Neurology

Title: Brain Tumor Imaging 101

Keywords: edema, hemorrhage, tumor, CT, MRI, contrast (PubMed Search)

Posted: 1/24/2018 by Danya Khoujah, MBBS (Updated: 9/27/2022)
Click here to contact Danya Khoujah, MBBS

Although MRI is more sensitive for identifying tumors of the CNS, CT is usually the first line imaging modality in the ED. Some pearls:

  • Hyperattenuation = bright = dense (blood)
  • Hypoattenuation = dark = radiolucent (fluid, air, lipid, scar)
  • Masses that are darker + increased volume or mass effect = edema (image 1)
  • Masses that are darker + decreased volume = scar tissue or atrophy (image 2)
  • Masses that are bright + edema = hemorrhage (image 3)
  • Adding IV contrast improves detection of tumors: abnormal enhancement from disruption of blood brain barrier, necrosis or increased vascularity. (Image 4)

Image 1 Courtesy of Radiopedia.orgImage 2: courtesy of Dr Chris O'Donnell, Radiopaedia.orgImage 3: courtesy of Dr David Cuete, Radiopaedia.orgImage 4: Courtesy of David Kernick, and Stuart Williams Br J Gen Pract2011;61:409-411

References

Klein JP, Dietrich J. Neuroradiologic Pearls for Neuro-oncology. Continuum 2017;23(6):1619-1634.