MR Appearance of Central Neurocytoma

Abstract

To provide a detailed description of the MR appearances of central neurocytoma, MR images of 13 patients with central neurocytoma were retrospectively reviewed and compared with CT examinations. The histology was confirmed by ultrastructural and immunohistochemical studies. In 12 patients the tumors were histologically benign and located in the anterior part of the lateral ventricle, 6 of which extended to the 3rd ventricle. There was one case of a histologically malignant variant involving the thalamus and lateral ventricle. The tumors were primarily solid, but contained cysts (85%,11/13), calcifications (69%,9/13), and signal void from tumor vessels (62%, 8/13), frequently producing heterogeneous signal intensity on both T'l-and T2-weighted images. Most of the solid portion appeared isointense or slightly hyperintense relative to the cerebral cortex on all MR pulse sequences. Calcifications were isoor hypointense on MR, making them difficult to characterize with MR alone. Intratumoral hemorrhage was seen in 2 patients on MR but not on CT. Contrast enhancement was variable in degree and pattern. Coronal and sagittal MR images were valuable in evaluating the tumor extent and origin site, and in planning the surgical approach. It is concluded that MR imaging appears to be more useful than CT in the overall evaluation of central neurocytoma, even though calcification is better characterized with CT.

Treatment strategies for huge central neurocytomas

“…MRI findings of huge CNs characteristically included third ventricle extension, attachment to the wall of the lateral ventricle, and heterogeneous hypointensity to isointensity on T1-weighted image and hyperintensity on T2-weighted image, with moderate contrast enhancement and regular vascular FVS. These neuroradiological features were clearly present in our series, strongly supporting the diagnosis of CNs [11,[13][14][15][16] .…”

“…Patients with huge CNs in our study usually presented with long-term headache and visual disturbance, and the mean duration of clinical symptoms and signs was much longer than the duration (less than 6 months) previously reported [10,11] . Huge CNs in our study, with diameter ≥5.0 cm and a broad-based attachment to the superior and lateral wall of the ventricle, were characterized by greater frequency among young adults, intraventricular location, and specific neuroradiological and histopathological features [11][12][13] . These 13 huge CNs occurred most commonly in young adults in the third decade of life and showed a slight male predominance.…”

A clinicopathological, immunohistochemical and neuroradiological study of eight patients with central neurocytoma

“…Even if intratumoral haemorrhage is of uncertain origin, it is a useful sign for differentiating CN from other intraventricular tumors that have a lesser tendency to bleed. 12 Only one patient in our series had areas of bleeding.…”

“…9,10 MRI showed a heterogeneous hypointensity on T1-weighted images and hyperintensity on T2-weighted images with a well-defined margin. 11,12 The presence of cystic components and calcifications cause heterogeneous signal changes. 9,10 After administration of gadolinium contrast all tumors showed heterogeneous enhancement; the degree of enhancement was minimal to marked.…”