Zusammenfassung
Routinemäßig wird bei vermuteter intrazerebraler Raumforderung eine Magnetresonanztomographie durchgeführt, meist ist auch eine Computertomographie indiziert. Die weitere Diagnostik sowie die Befundinterpretation differieren in Abhängigkeit von der Tumorart. Im vorliegenden Beitrag wird auf die Symptome und die Diagnostik der supratentoriellen Tumoren eingegangen, und zwar getrennt nach intra- bzw. extrakranialer Lokalisation. Zu den supratentoriellen intrakranialen Tumoren sind zu rechnen: Astrozytome, die nach umschriebenem und diffusem Wachstum unterschieden werden, Gangliogliome, Ganglioneurome, Ependymome, Neurozytome, primitive neuroektodermale Tumoren (PNET), Oligodendrogliome, dysembryoplastische neuroepitheliale Tumoren (DNET), Meningeoangiomatosen, Pinealistumoren, Hamartome, Lymphome, Kraniopharyngeome sowie Metastasen. Zu den supratentoriellen extrakranialen Tumoren gehören Tumoren des Plexus choroideus, Kolloidzysten, Meningeome, infantile Myofibromatose und Lipome. Auch die häufigsten Unterformen dieser Raumforderungen, insbesondere der Astrozytome, werden vorgestellt.
Abstract
Magnetic resonance imaging is a routine diagnostic measure for a suspected intracerebral mass. Computed tomography is usually also indicated. Further diagnostic procedures as well as the interpretation of the findings vary depending on the tumor location. This contribution discusses the symptoms and diagnostics for supratentorial tumors separated in relation to their intra- or extracranial location. Supratentorial tumors include astrocytoma, differentiated by their circumscribed and diffuse growth, ganglioglioma, ependyoma, neurocytoma, primitive neuroectodermal tumors (PNET), oligodendroglioma, dysembryoplastic neuroepithelial tumors (DNET), meningoangiomatosis, pineal tumors, hamatoma, lymphoma, craniopharyngeoma and metastases. The supratentorial extracranial tumors include the choroid plexus, colloid cysts, meningeoma, infantile myofibromatosis and lipoma. The most common sub-forms, especially of astrocytoma, will also be presented.
Literatur
Alnaghmoosh N, Alkhani A (2006) Colloid cysts in children, a clinical and radiological study. Childs Nerv Syst 22: 514–516
Armao D, Castillo M, Chen H et al. (2000) Colloid cyst of the third ventricle: imaging-pathologic correlation. AJNR Am J Neuroradiol 21: 1470–1477
Baehring JM, Hochberg FH (2006) Primary lymphoma of the nervous system. Cancer J 12: 1–13
Brainer-Lima PT, Brainer-Lima AM, Azevedo-Filho HR (2006) Ganglioglioma: comparison with other low-grade brain tumors. Arq Neuropsiquiatr 64: 613–618
Chamberlain MC (2003) Ependymomas. Curr Neurol Neurosci Rep 3: 193–199
Chen CJ, Tseng YC, Hsu HL et al. (2004) Related articles, imaging predictors of intracranial ependymomas. J Comput Assist Tomogr 28: 407–413
Chowdhary S, Chamberlain MC (2000) Oligodendroglial tumors. Exp Rev Neurother 6: 519–532
Craver RD, Nadell J, Nelson JS (1999) Desmoplastic infantile ganglioglioma. Pediatr Dev Pathol 2: 582–587
Cuccia V, Rodriguez F, Palma F et al. (2006) Pinealoblastomas in children. Childs Nerv Syst 22: 577–585
Curran JG, O’Connor E (2005) Imaging of craniopharyngioma. Childs Nerv Syst 21: 635–639
Daumas-Duport C, Varlet P, Tucker ML et al. (1997) Oligodendrogliomas. Part I: Patterns of growth, histological diagnosis, clinical and imaging correlations: a study of 153 cases. J Neurooncol 34: 37–59
Daumas-Duport C, Tucker ML, Kolles H et al. (1997) Oligodendrogliomas. Part II: A new grading system based on morphological and imaging criteria. J Neurooncol 34: 61–78
Essig M, Waschkies M, Wenz F et al. (2003) Assessment of brain metastases with dynamic susceptibility-weighted contrast-enhanced MR imaging: initial results. Radiology 228: 193–199
Gotthardt M, Dijkgraaf I, Boerman OC et al. (2006) Nuclear medicine imaging and therapy of neuroendocrine tumours. Cancer Imaging 31: S178–S184
Grobben B, De Deyn PP, Slegers H (2002) Rat C6 glioma as experimental model system for the study of glioblastoma growth and invasion. Cell Tissue Res 310: 257–270
Hochberg FH, Baehring JM, Hochberg EP (2007) Primary CNS lymphoma. Nat Clin Pract Neurol 3: 24–35
Ichikawa T, Kumazaki T, Mizumura S et al. (2000) Intracranial lipomas: demonstration by computed tomography and magnetic resonance imaging. J Nippon Med Sch 67: 388–391
Izbicka E, Izbicki T (2005) Therapeutic strategies for the treatment of neuroblastoma. Curr Opin Invest Drugs 6: 1200–1214
Jensen RL, Caamano E, Jensen EM et al. (2006) Development of contrast enhancement after long-term observation of a dysembryoplastic neuroepithelial tumor. J Neurooncol 78: 59–62
Jeuken JW, Deimling A von, Wesseling P (2004) Molecular pathogenesis of oligodendroglial tumors. J Neurooncol 70: 161–181
Karavitaki N, Cudlip S, Adams CB et al. (2006) Craniopharyngiomas. Endocr Rev 27: 371–397
Kimura H, Takeuchi H, Koshimoto Y et al. (2006) Perfusion imaging of meningioma by using continuous arterial spin-labeling: comparison with dynamic susceptibility-weighted contrast-enhanced MR images and histopathologic features. AJNR Am J Neuroradiol 27: 85–93
Komotar RJ, Mocco J, Jones JE et al. (2005) Pilomyxoid astrocytoma: diagnosis, prognosis, and management. Neurosurg Focus 18: E7
Korogi Y, Takahashi M, Ushio Y (2001) MRI of pineal region tumors. J Neurooncol 54: 251–261
Kujas M (1993) Meningioma. Curr Opin Neurol 6: 882–887
Kuo JS, Casey SO, Thompson L et al. (1999) Pallister-Hall syndrome: clinical and MR features. AJNR Am J Neuroradiol 20: 1839–1841
Lantos PL,Vandenberg SR,Kleihues P (1997) Paraneoplastic syndromes. In: Graham DI, Lantos PL (eds) Greenfield’s neuropathology. Arnold, London, pp 791–795
Liu GT, Galetta SL, Rorke LB et al. (1996) Gangliogliomas involving the optic chiasm. Neurology 46: 1669–1673
Luyken C, Blumcke I, Fimmers R et al. (2004) Supratentorial gangliogliomas: histopathologic grading and tumor recurrence in 184 patients with a median follow-up of 8 years. Cancer 101: 146–155
Meltzer CC, Liu AY, Perrone AM et al. (1998) Meningioangiomatosis: MR imaging with histopathologic correlation. AJR Am J Roentgenol 170: 804–805
Miranda P, Lobato RD, Ricoy JR et al. (2005) Xanthogranuloma of the choroid plexus of the third ventricle: case report and literature review. Neurocirugia (Astur) 16: 518–522
Molla E, Marti-Bonmati L, Revert A et al. (2002) Craniopharyngiomas: identification of different semiological patterns with MRI. Eur Radiol 12: 1829–1836
Nomura M, Yamashima T, Hibino M et al. (2000) Cerebral meningioangiomatosis: MRI and MRS findings. Acta Neurochir (Wien) 142: 829–831
Perry A, Gutmann DH, Reifenberger G (2004) Molecular pathogenesis of meningiomas. J Neurooncol 70: 183–202
Prados MD, Levin V (2000) Biology and treatment of malignant glioma. Semin Oncol [Suppl 6] 27: 1–10
Rao RD, James CD (2004) Altered molecular pathways in gliomas: an overview of clinically relevant issues. Semin Oncol 31: 595–604
Reis F, Faria AV, Zanardi VA et al. (2006) Neuroimaging in pineal tumors. J Neuroimaging 16: 52–58
Robben SG, Tanghe HL, Drop SL (1994) Hypothalamic hamartoma. J Belge Radiol 77: 221
Rutka JT, Hoffman HJ (1996) Medulloblastoma: a historical perspective and overview. J Neurooncol 29: 1–7
Sarabino T, Giannatempo GM, Nemore F et al. (2005) Supratentorial low-grade gliomas. J Neurosurg Sci 49: 73–76
Schellinger PD, Meinck HM, Thron A (1999) Diagnostic accuracy of MRI compared to CCT in patients with brain metastases. J Neurooncol 44: 275–281
Schiffer D, Giordana MT (1998) Prognosis of ependymoma. Childs Nerv Syst 14: 357–361
Scott JN, Brasher PM, Sevick RJ et al. (2002) How often are nonenhancing supratentorial gliomas malignant? A population study. Neurology 59: 947–949
Scroop R, Voyvodic F, Sage MR (2000) Meningioangiomatosis. Australas Radiol 44: 460–463
Sgouros S, Carey M, Aluwihare N et al. (1998) Central neurocytoma: a correlative clinicopathologic and radiologic analysis. Surg Neurol 49: 197–204
Shin JH, Lee HK, Khang SK et al. (2002) Neuronal tumors of the central nervous system: radiologic findings and pathologic correlation. Radiographics 22: 1177–1189
Stautz CC (1990) Magnetic resonance evaluation of infantile myofibromatosis. Mo Med 87: 889–891
Tamburrini G, Colosimo C Jr, Giangaspero F et al. (2003) Desmoplastic infantile ganglioglioma. Childs Nerv Syst 19: 292–297
Tamburrini G, Gessi M, Colosimo C Jr et al. (2003) Infantile myofibromatosis of the central nervous system. Childs Nerv Syst 19: 650–654
Taranath A, Lam A, Wong CK (2005) Desmoplastic infantile ganglioglioma: a questionably benign tumour. Australas Radiol 49: 433–437
Tasch E, Cendes F, Li LM et al. (1998) Hypothalamic hamartomas and gelastic epilepsy: a spectroscopic study. Neurology 51: 1046–1050
Tervonen O, Forbes G, Scheithauer BW et al. (1992) Diffuse „fibrillary“ astrocytomas: correlation of MRI features with histopathologic parameters and tumor grade. Neuroradiol 34: 173–178
Whittle IR, Smith C, Navoo P et al. (2004) Meningiomas. Lancet 363: 1535–1543
Wilms G (2001) MR imaging of colloid cysts of the third ventricle. AJNR Am J Neuroradiol 22: 1632
Wiswell TE (1988) Infantile myofibromatosis and the use of magnetic resonance imaging. Am J Dis Child 142: 486
Yildiz H, Hakyemez B, Koroglu M et al. (2006) Intracranial lipomas: importance of localization. Neuroradiology 48: 1–7
Yilmaz N, Unal O, Kiymaz N et al. (2006) Intracranial lipomas – a clinical study. Clin Neurol Neurosurg 108: 363–368
Young RJ, Sills AK, Brem S et al. (2005) Neuroimaging of metastatic brain disease. Neurosurgery [Suppl 5] 57: S10–S23; S1–S4
Zali A, Shahzadi S, Mohammad-Mohammadi A et al. (2007) Cerebral lymphoma: clinical and radiological findings in 90 cases. Arch Iran Med 10: 194–198
Zentner J, Wolf HK, Ostertun B et al. (1994) Gangliogliomas: clinical, radiological, and histopathological findings in 51 patients. J Neurol Neurosurg Psychiatry 57: 1497–1502
Zhang D, Wen L, Henning TD et al. (2006) Central neurocytoma: clinical, pathological and neuroradiological findings. Clin Radiol 61: 348–357
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Grunwald, I., Dillmann, K., Roth, C. et al. Supratentorielle Tumoren. Radiologe 47, 471–485 (2007). https://doi.org/10.1007/s00117-007-1519-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00117-007-1519-3
Schlüsselwörter
- Intrazerebrale Raumforderung
- Magnetresonanztomographie
- Computertomographie
- Intrakraniale Tumoren
- Extrakraniale Tumoren