Dynamic contrast enhanced magnetic resonance imaging findings of mass lesions of the pontocerebellar angle

Abstract

The differential diagnosis of mass lesions of the pontocerebellar angle is not always possible by conventional magnetic resonance imaging (MRI). In this study, we investigated the role of dynamic contrast-enhanced MRI in the differential diagnosis of acoustic neurinoma, meningioma, and paraganglioma. Twelve patients (8 females, 4 males; mean age 47.5 years; range 8 to 71 years) whose diagnoses were acoustic neurinoma (n=3), paraganglioma (n=5), and meningioma (n=4) were evaluated by simultaneous conventional and dynamic contrast-enhanced MRI. Prior to postcontrast T1-weighted images, dynamic MRI was obtained. On these images, maximum contrast enhancement (Cmax) and time to peak enhancement (Tmax) were calculated at 15 different time points. Time-signal intensity curve patterns of the lesions were compared. According to the four main time-signal intensity curve patterns described in the literature, acoustic neurinomas, meningiomas, and paragangliomas exhibited type C, type A-B, and type A curve patterns, respectively. Our results suggest that dynamic contrast MRI may have an additional but limited role in the differential diagnosis of extra-axial intracranial tumors such as those of the pontocerebellar angle.