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Question
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50yrs lady presented with gradual onset ataxia and left ear hearing loss. MRI is shown below. The likely diagnosis is:
Explanation
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Epidermoids are often indistinguishable fromarachnoid cystsor dilated CSF spaces on many MR sequences, except for DWI/ADC which helps to differentiate them<br>T1 usually isointense to CSF<br>T1 C+(Gd) thin enhancement around the periphery may sometimes be seen<br>T2 usually isointense to CSF (65%)<br>FLAIR often heterogeneousdirty signal higher than CSF<br>DWI/ADC: very bright on DWI<br>- similar ADC values compared to adjacent brain parenchyma<br>- useful for differentiation from arachnoid cysts due to increased signal (due to a combination of abnormal restricted diffusion andT2 shine through), which is not seen with arachnoid cysts
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Reference
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Grossman RI, Yousem DM. Neuroradiology, the requisites. Mosby Inc. (2003)
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Option 1
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Is Correct (Option 1):
Acoustic schwannoma
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Option 2
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Is Correct (Option 2):
Epidermoid cyst
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Option 3
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Is Correct (Option 3):
Enplaque meningioma
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Option 4
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Is Correct (Option 4):
Neurocytoma
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