BRAIN SPACE OCCUPYING LESIONS

Role of conventional radiograph No significant role

Role of CT and MRI

exact location nature (cystic or solid or mixed) benign or malignant appearing extent and staging essential in preoperative plan points that help diagnosis margin homogeneity density or intensity perifocal edema mass effect contrast behavior contents (air, fat ,CSF, protein, etc.) associated calcification associated hemorrhage

CT

protocols
routinely axial cuts direct coronal reconstruction contrast use window settings(bone and soft-tissue)

Has advantage for

calcification cortical bony masses acute hemorrhage short time MRI

Advantages

Multiplanner Excellent soft-tissue differentiation Avoid posterior fossa artifact MR angiography without contrast Of choice in evaluation of cranial nerve lesions

Protocols

T1WIs axial coronal and sagittal T2WIs same FLAIR(for attenuation of CSF) STIR (for fat suppression )
Pituitary (T1 coronal with and without contrast Medullary cervical junction best seen on sagittal T2

Brain space occupying lesion can be

---- neoplastic (benign , malignant, metastasis. Cystic or solid or mixed) supra
or infra tentorial , intraventricular ---- inflammatory ---- vascular ---- traumatic ---- bony extension