Emergency Imaging of Brain Tumors: Introduction/Role of Imaging
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- čas přidán 16. 05. 2024
- Hi everyone! In this video, we’re going to talk about the emergent imaging of brain tumors, particularly as it applies to a general approach when you might see patients like this coming through the emergency department. We’ll have a special emphasis on computed tomography throughout this lecture. This is the ideal lecture for someone who practices neuroradiology and sees some patients with brain tumors, but isn’t exactly a brain tumor expert.
0:00 Introduction
0:38 Role of imaging brain tumors in emergencies. There are 2 main tools for imaging brain tumors, CT and MRI. CT is the screening tool for initial identification of a potential mass and then evaluating complications such as hemorrhage, edema, mass effect, hydrocephalus, and herniation. However, MRI is the mainstay of tumor evaluation used for evaluation of tumor type, tumor worsening, and tumor details.
2:40 MRI. MRI is used to make a more specific initial diagnosis, for pre-treatment planning, and for follow-up after surgery and treatment. It will almost always have FLAIR, diffusion weighted imaging (DWI), and pre- and post-contrast T1 imaging. A few other tools are used for troubleshooting, such as perfusion and functional MRI (fMRI).
3:37 FLAIR. This is a key sequence for evaluating a mix of edema and infiltrative tumor. It is the best comparison for CT
4:33 Pre- and post-contrast T1. Areas of post-contrast enhancement show areas of breakdown of the blood brain barrier. This can happen when the tumor itself has disrupted it or when there has been tissue damage from radiation therapy. More aggressive tumors have more enhancement
5:20 Role of emergent imaging. When a patient comes to the ER, if a patient doesn’t have a known tumor, you might use it to identify a potential tumor, give a practical differential, and recommend next steps. In patients with tumors, you might use it to identify urgent complications. The role of emergent imaging is not to give an exact diagnosis or assess tumor progression.
6:18 Summary. In this video, we have covered some of the basics of imaging patients with brain tumors in emergent situations, including when CT and MRI are most appropriate.
This is the first lecture in this series about imaging brain tumors in the emergent setting. Hopefully you learned a little bit about the role of different imaging types. The next lectures are going to discuss some additional topics in detail, including how to classify these tumors, how to interpret common imaging studies, and how to avoid red flags.
Thanks for tuning in. Be sure to check out the other videos on the brain tumor topic page if you want to learn more about brain tumors.
Check out this video and additional content on www.learnneuroradiology.com
THANKS
You're welcome!
Thanks for amazing lectures. Could you do a video on how to evaluate for extent of resection after surgery? How to diferenciate from post surgical changes?
This is a great idea and I'm putting it on my to-do list. Which is long but I'll get to it eventually 😂
@@LearnNeuroradiology Ill be waiting. Also would be great if you added some long term evaluation post radiation or chemo therapy, pseudo-progression etc. (in the same lecture or separate)
Those lectures I actually have, but aren't yet recorded, so that is much closer to reality.
In the meantime, you might check out another effort I work on, the Brain Tumor-Radiology Data and Reporting System. www.btrads.com. It has a lot of useful tools and links for thinking about post-operative reporting
@@LearnNeuroradiology thank you once again for the great work youre doing. I hope you wont go behind the paywall as some of other radiologists did that Im following.
@@Gragon Nah, I don't really do this for the money. I get a little money from ads that I just use to pay for hosting and other minor stuff.
Glad you enjoy!
Really informative and helpful
Glad it was helpful!
great brain tumor series to learn,
glad you enjoyed it!
Sir
Iam 27 years old
Recently diagnosed with oligodendroglioma grade 3 ( right temporal lobe)
My surgery completed successfully (Alhamdulillah)
My surgeon said he removed all the tumor but if there something microscopic cells left there we can’t see with eyes for that they are going to give me 6 week radiation with chemo pills
Sir if it can be cured or not
Sir can you reply me please
Grade 3 oligodendrogliomas typically are not permanently cured by treatment, as there is no 100% cure for these tumors. They have a relatively high risk of coming back over the years, which is why it's important to get radiation and chemotherapy to minimize that risk.
In all likelihood, they will want to continually monitor you with MRIs every so often to see if if it comes back so they can retreat if it does.
With treatment, however, people can have good function and go a relatively long time without the tumor coming back. Be sure to talk to your doctor about your concerns.
Are there any tumors that could cause central necrosis and edema besides a glioblastoma? My grandma had emergency surgery on a large mass in her brain that was causing severe cognitive effects and the doctors never said what type of tumor it was. She also has lung cancer the doctors said it spread. But I’m worried it was something else
First, I'm sorry to hear about your grandma. I hope she does well after the surgery.
There are a couple of things to think about, the main one being metastases (spread of another cancer to the brain). If she has long cancer, that may be the most likely. Infections can also sometimes look like tumors.