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: 6/24/2024)
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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


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