Legend
Left: axial T2WI shows a large, mildly hyperintense mass in the mid frontal
region with significant mass effect on the adjacent parenchyma. The frontal
horns of the lateral ventricles are compressed and the atria are dilated.
Two distinct areas of hyperintensity similar to CSF flank this mass. There is
an area without signal on the left anteriorly, contiguous to the hyperintensity
posteriorly. This configuration suggests air- fluid level.
Right: axial T1WI shows that this mass is mildly hypointense. The cystic
components posteriorly are higher signal than normal CSF on T1WI.
The area without signal in the left frontal region is again seen.
Legend
Left: axial T1WI image more superiorly shows similar findings. There is
a collection of epidural hyperintensity in the frontal region.
Middle: axial T1WI at the level of orbits shows isointense expansile masses
in the ethmoid sinuses and nasal cavity, extending into the orbits.
Right: axial T1WI with gadolinium shows ring-enhancing masses with area
of more homogeneous enhancement near the midline. The left frontal horn
is completely obliterated. Note the air-fluid level in the left frontal region.
Legend
Left: axial T1WI with gadolinium shows again large midline enhancing
mass with two smaller components in the periphery that have low internal
signals. Note again the air-fluid level.
Middle and right: coronal T1WI's with gadolinium show that this large
mass centers near the cribriform plate with extensive involvement of the
ethmoid sinuses, nasal cavity and orbits, and superior extension into the
anterior cranial fossa.
Key words: mri tumor neoplasia
Brain & ENT Diagnosis:
Esthesioneuroblastoma