The purpose of our study is to evaluate CT and MRI findings of 4th ventricular tumors and to find differential points of 4th ventricular tumors.
On MRI, all tumors(11 cases) were low to iso-signal intensity on T1W1 and iso-to high signal intensity on T2WI except medulloblastoma(1 case) showing low to iso-signal intensity. On Gd-DTPA enhanced T1WI, all medulloblastomas(6 cases) showed
dense
inhomogeneous enhancement, all ependymomas(3 cases) showed moderate inhomogeneous enhancement, and all choroid plexus papillomas(2 cases) showed dense homogenous enhancement. On CT, one choroid plexus papilloma showed dense calcification.
All medulloblastomas showed anterior(1 cases) or anterolateral(5 cases) CSF-cleft in axial MRI or CT and anterior beaking of upper 4th ventricle on sagittal MRI. All ependymomas showed posterior(1 case) and both sided(1 case) and both sided
CSF-cleft on
axial MRI and CT, and both sided beaking of upper 4th ventricle on sagittal MRI. Choroid plexus papillomas showed both sided CSF-cleft on axial MRI and CT, and beaking or upper 4th ventricle on sagittal MRI.
All medulloblastomas and ependymomas showed smooth or lobulated margin, but choroid plexus papillomas showed serrated margin.
The results of our study with MRI and CT may suggest that specific diagnosis of 4th ventricular tumor can be done preoperatively by analysis of the CSF-cleft pattern of 4th ventricle in axial images and pattern of beaking of upper 4th ventricle
in
sagittal image, tumor margin, enhancement pattern, and miscellaneous findings.
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