J Neurol Surg B Skull Base 2020; 81(02): 172-179
DOI: 10.1055/s-0039-1681039
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Evaluation of Skull Base Tumors with Dynamic TurboFLASH MRI during Gadolinium Injection

Guido Trasimeni
1   Division of Neuroradiology, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), “Sapienza” University of Rome, Rome, Italy
,
Marina Auconi
1   Division of Neuroradiology, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), “Sapienza” University of Rome, Rome, Italy
,
Andrea Grossi
1   Division of Neuroradiology, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), “Sapienza” University of Rome, Rome, Italy
,
Olga Gagliardo
1   Division of Neuroradiology, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), “Sapienza” University of Rome, Rome, Italy
,
Andrea Romano
1   Division of Neuroradiology, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), “Sapienza” University of Rome, Rome, Italy
,
Edoardo Covelli
2   Otolaryngology Clinic, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), “Sapienza” University of Rome, Rome, Italy
,
Alessandro Bozzao
1   Division of Neuroradiology, Department of Neurosciences, Mental Health and Sensory Organs (NESMOS), “Sapienza” University of Rome, Rome, Italy
› Author Affiliations
Further Information

Publication History

17 October 2018

27 January 2019

Publication Date:
15 March 2019 (online)

Abstract

Background and Purpose This study was aimed to investigate the role of dynamic TurboFLASH gadolinium (Gd) magnetic resonance (MR) imaging in improving the differential diagnosis of skull base tumors.

Methods Eleven patients with skull base tumors underwent standard MR and ultrafast TurboFLASH sequence during gadolinium injection.

Results The characterization of tumor vascularity was performed. Different patterns of gadolinium uptake for each tumor type were observed. This is particularly important to identify tumors at high risk of intraoperative bleeding. All glomus tumors, typically highly vascularized, showed an enhancement at the arterial phase, reflecting the arterialization of these tumors which is not detectable on conventional MR. No signal increase at the arterial phase was instead observed in other cases in which the ruling out of a glomus tumor was important because of the location of the lesion. Moreover TurboFLASH identified the pathognomonic “filling-in” profile of cavernous sinus cavernous hemangiomas (CSCH), that is, the progressive centripetal enhancement of the lesion at the beginning of the venous phase.

Conclusion The dynamic analysis of tumor contrast enhancement with the TurboFLASH sequence provides useful additional information to that obtained with conventional MR, improving the differential diagnosis of skull base tumors, particularly in the distinction between glomus and nonglomus tumors and in diagnosing CSCH.

Financial Disclosure

The authors received no material or financial sources of support for this manuscript.


 
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