Browse > Article
http://dx.doi.org/10.3340/jkns.2016.59.5.466

Craniopharyngiomas : Radiological Differentiation of Two Types  

Lee, In Ho (The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions)
Zan, Elcin (The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions)
Bell, W. Robert (Department of Pathology, The Johns Hopkins Medical Institutions)
Burger, Peter C. (Department of Pathology, The Johns Hopkins Medical Institutions)
Sung, Heejong (Genometrics Section, Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health)
Yousem, David M. (The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions)
Publication Information
Journal of Korean Neurosurgical Society / v.59, no.5, 2016 , pp. 466-470 More about this Journal
Abstract
Objective : To determine imaging features that may separate adamantinomatous and papillary variants of craniopharyngiomas given that tumors with adamantinomatous signature features are associated with higher recurrence rates, morbidity, and mortality. We specifically reviewed calcification on CT, T1 bright signal intensity, and cystic change on T2 weighted images for differentiating these two types. Methods : We retrospectively reviewed the MRI and CT studies in 38 consecutive patients with pathologically proven craniopharyngiomas between January 2004 and February 2014 for the presence of calcification on CT scans, bright signal intensity on T1 weighted images, and cystic change on T2 weighted images. Results : Of the 38 craniopharyngiomas, 30 were adamantinomatous type and 8 were papillary type. On CT scans, calcification was present in 25 of 38 tumors. All calcified tumors were adamantinomatous type. Twenty four of 38 tumors had bright signal intensity on T1 weighted images. Of these 24 tumors, 22 (91.7%) were adamantinomatous and 2 were papillary type. Cystic change on T2 weighted images was noted in 37 of 38 tumors; only 1 tumor with papillary type did not show cystic change. Conclusion : T1 bright signal intensity and calcification on CT scans uniformly favor the adamantinomatous type over papillary type of craniopharyngioma in children. However, these findings are more variable in adults where calcification and T1 bright signal intensity occur in 70.6% and 58.8% respectively of adult adamantinomatous types of craniopharyngiomas.
Keywords
Craniopharyngioma; Tomography scanners; X-ray computed; Magnetic resonance imaging;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Crotty TB, Scheithauer BW, Young WF Jr, Davis DH, Shaw EG, Miller GM, et al. : Papillary craniopharyngioma : a clinicopathological study of 48 cases. J Neurosurg 83 : 206-214, 1995   DOI
2 Curran JG, O'Connor E : Imaging of craniopharyngioma. Childs Nerv Syst 21 : 635-639, 2005   DOI
3 De Vile CJ, Grant DB, Kendall BE, Neville BG, Stanhope R, Watkins KE : Management of childhood craniopharyngioma : can the morbidity of radical surgery be predicted? J Neurosurg 85 : 73-81, 1996   DOI
4 Duff J, Meyer FB, Ilstrup DM, Laws ER Jr, Schleck CD, Scheithauer BW : Long-term outcomes for surgically resected craniopharyngiomas. Neurosurgery 46 : 291-302, 2000   DOI
5 Eldevik OP, Blaivas M, Gabrielsen TO, Hald JK, Chandler WF : Craniopharyngioma : radiologic and histologic findings and recurrence. AJNR Am J Neuroradiol 17 : 1427-2439, 1996
6 Fisher PG, Jenab J, Gopldthwaite PT, Tihan T, Wharam MD, Foer DR : Outcomes and failure patterns in childhood craniopharyngiomas. Childs Nerv Syst 14 : 558-563, 1998   DOI
7 Gautier A, Godbout A, Grosheny C, Tejedor I, Coudert M, Courtillot C, et al. : Markers of recurrence and long-term morbidity in craniopharyngioma : a systematic analysis of 171 patients. J Clin Endocrinol Metab 97 : 1258-1267, 2012   DOI
8 Kim SK, Wang KC, Shin SH, Choe G, Chi JG, Cho BK : Radical excision of pediatric craniopharyngioma : recurrence pattern and prognostic factors. Childs Nerv Syst 17 : 531-536, 2001   DOI
9 Gupta DK, Ojha BK, Sarkar C, Mahapatra AK, Mehta VS : Recurrence in craniopharyngiomas : analysis of clinical and histological features. J Clin Neurosci 13 : 438-442, 2006   DOI
10 Jo KW, Shin HJ, Kong DS, Seol HJ, Nam DH, Lee JI : Treatment outcomes of pediatric craniopharyngioma : a 15-year retrospective review of 35 cases. J Korean Neurosurg Soc 52 : 37-41, 2012   DOI
11 Adamson TE, Wiestler OD, Kleihues P, Yasargil MG : Correlation of clinical and pathological features in surgically treated craniopharyngiomas. J Neurosurg 73 : 12-17, 1990   DOI
12 Ahmadi J, Destian S, Apuzzo ML, Segall HD, Zee CS : Cystic fluid in craniopharyngiomas : MR imaging and quantitative analysis. Radiology 182 : 783-785, 1992   DOI
13 Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM : The descriptive epidemiology of craniopharyngioma. J Neurosurg 89 : 547-551, 1998   DOI
14 Komotar RJ, Roguski M, Bruce JN : Surgical management of craniopharyngiomas. J Neurooncol 92 : 283-296, 2009   DOI
15 Miller DC : Pathology of craniopharyngiomas : clinical import of pathological findings. Pediatr Neurosurg 21 suppl 1 : 11-17, 1994   DOI
16 Sartoretti-Schefer S, Wichmann W, Aguzzi A, Valavanis A : MR differentiation of adamantinous and squamous-papillary craniopharyngiomas. AJNR Am J Neuroradiol 18 : 77-87, 1997
17 Pekmezci M, Louie J, Gupta N, Bloomer MM, Tihan T : Clinicopathological characteristics of adamantinomatous and papillary craniopharyngiomas : University of California, San Francisco experience 1985-2005. Neurosurgery 67 : 1341-1349, 2010   DOI
18 Petito CK : Craniopharyngioma : prognostic importance of histologic features. AJNR Am J Neuroradiol 17 : 1441-1442, 1996
19 Prabhu VC, Brown HG : The pathogenesis of craniopharyngiomas. Childs Nerv Syst 21 : 622-627, 2005   DOI
20 Shapiro K, Till K, Grant DN : Craniopharyngiomas in childhood. A rational approach to treatment. J Neurosurg 50 : 617-623, 1979   DOI
21 Szeifert GT, Sipos L, Horvath M, Sarker MH, Major O, Salomvary B, et al. : Pathological characteristics of surgically removed craniopharyngiomas : analysis of 131 cases. Acta Neurochir (Wien) 124 : 139-143, 1993   DOI
22 Tavangar SM, Larijani B, Mahta A, Hosseini SM, Mehrazine M, Bandarian F : Craniopharyngioma : a clinicopathological study of 141 cases. Endocr Pathol 15 : 339-344, 2004   DOI
23 Warakaulle DR, Anslow P : Differential diagnosis of intracranial lesions with high signal on T1 or low signal on T2-weighted MRI. Clin Radiol 58 : 922-933, 2003   DOI
24 Molla E, Marti-Bonmati L, Revert A, Arana E, Menor F, Dosda R, et al. : Craniopharyngiomas : identification of different semiological patterns with MRI. Eur Radiol 12 : 1829-1836, 2002   DOI
25 Zimny A, Zinska L, Bladowska J, Neska-Matuszewska M, Sasiadek M : Intracranial lesions with high signal intensity on T1-weighted MR images - review of pathologies. Pol J Radiol 78 : 36-46, 2013   DOI
26 Weiner HL, Wisoff JH, Rosenberg ME, Kupersmith MJ, Cohen H, Zagzag D : Craniopharyngiomas : a clinicopathological analysis of factors predictive of recurrence and functional outcome. Neurosurgery 35 : 1001-1010, 1994   DOI
27 Zacharia BE, Bruce SS, Goldstein H, Malone HR, Neugut AI, Bruce JN : Incidence, treatment and survival of patients with craniopharyngioma in the surveillance, epidemiology and end results program. Neuro Oncol 14 : 1070-1078, 2012   DOI
28 Zhang YQ, Wang CC, Ma ZY : Pediatric craniopharyngiomas : clinicomorphological study of 189 cases. Pediatr Neurosurg 36 : 80-84, 2002   DOI
29 Zhao X, Yi X, Wang H, Zhao H : An analysis of related factors of surgical results for patients with craniopharyngiomas. Clin Neurol Neurosurg 114 : 149-155, 2012   DOI