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Brain Tumors and Neurosurgeon Neuroradiologist Relations

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"nToday the modality of choice for brain tumors is MRI with and without GD. "nGD injection needs during to stage T1, before injection and after injection for image subtracts to see the enhancement degree, detecting crystallized calcification, colloid and fat material also methemoglubin inside the tumor. "n- In case of thin layer seeding, GD MRI could be positive but T2 and FLAIR images could be negative "no mass effect". "n- For meningiomas if you do not want to inject contrast media please request plain CT SCAN that is stronger than non-contrasted MRI but GD MRI is the choice and better than both. "n- For small or micro-vestibular schwannoma do not request CT please request MRI with GD. "n- In craniopharyngioma request non-contrast CT with combination of MRI with and without GD. "n- For micro-adenoma request dynamic MRI "better than Dynamic CT" "n- please do not use axial CT and non-contrasted coronal CT for micro-adenoma". "n- Few infiltrative non-enhancing tumors need serial MRI to be differentiated from CVA. "n- For differentiation of tumor recurrency from radiotherapy necrosis MRS is necessary. "nOther lecture notes will be discussed in the round table.

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