Left: Axial T2WI at the level of tentorium shows isointense left occipital mass
with surrounding mass effect.
Middle: Axial T2WI at the level of cerebellum shows left cerebellum
hyperintensity with mass effect on the vermis.
Right: FLAIR image shows this mass is slightly hyperintense to brain
parenchyma. Adjacent area of focal hyperintensity is noted.
T1WI's pre-gadolinium sagittal (left top) and post-gadolinium (left bottom, sagittal;
right top, coronal; right bottom, axial) show the mass is isointense, transtentorial and
parasagittal in location. It is broad-based along the tentorium and posterior dura,
and the mass enhances homogeneously.
Top left: PA view of the left vertebral angiogram shows filling of the tentorial mass
in the arterial phase. There is reflux filling of the right vertebral artery.
Bottom left: Capillary phase shows marked vascularity of this lesion.
Top right: Venous phase shows retention of contrast within this mass. Narrowing of
the left transverse sinus can be appreciated.
Bottom right: PA view of venous phase of the left ICA injection shows again the
narrowing of the left transverse sinus
Lateral projections of the same angiographic studies seen in page 3.
Arterial phases (left) reveal a large feeding meningeal artery to the hypervascular mass.
The arterial blush persists in the venous phase (top right). Narrowing of the superior
sagittal sinus above the torcular herophili can now be seen on the sagittal view in LICA
injection (bottom right).
Key words: mri angiogram angiography tumor neoplasia
Tentorial meningioma -
stenoses of superior sagittal
& left transverse sinuses