J Korean Neurosurg Soc.  2016 Sep;59(5):466-470. 10.3340/jkns.2016.59.5.466.

Craniopharyngiomas : Radiological Differentiation of Two Types

• Lee IH
• Zan E
• Bell WR
• Burger PC
• Sung H
• Yousem DM

• KMID: 2351714
• DOI: http://doi.org/10.3340/jkns.2016.59.5.466

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.

Keyword

Craniopharyngioma; Tomography scanners, X-ray computed; Magnetic resonance imaging

MeSH Terms

Adult
Child
Craniopharyngioma*
Humans
Magnetic Resonance Imaging
Mortality
Recurrence
Retrospective Studies
Tomography Scanners, X-Ray Computed
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 2-year old boy with craniopharyngioma (adamantinomatous type). A : Sagittal T1 weighted image shows diffuse bright signal intensity (arrow) in the sellar and suprasellar mass. B : Non-contrast axial CT scan shows curvilinear high density (arrowheads) in the peripheral portion of mass, indicating calcification.

• 

  Fig. 2 10-year old boy with craniopharyngioma (adamantinomatous type). A : Sagittal T1 weighted image shows bright signal intensity (arrow) in the lower portion of sellar and suprasellar mass. B : Non-contrast axial CT scan shows curvilinear high density (arrowheads) in the peripheral portion of mass, indicating calcification.

• 

  Fig. 3 54-year old woman with craniopharyngioma (papillary type). A : Sagittal T1 weighted image shows no bright signal intensity (arrow) in the sellar and suprasellar mass. B : Non-contrast axial CT scan shows no high density in the mass, indicating calcification.

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