CT and MRI diagnosis of cerebral and spinal hemangioblastomas

Objective:To study the imaging features of cerebral and spinal hemangioblastomas with CT,MR scanning and MR perfusion weighted imaging (PWI).Methods:All 44 patients were pathologically proved cerebellar or spinal hemangioblastomas.Plain and contrast enhanced CT were performed in 31 patients, and plain and contrast enhanced MRI were performed in 16 patients. Additional PWI was performed in 5 patients, and both CT and MRI were performed in 3 patients.Results:Among the 44 cases,27 appeared as large cyst with mural nodule,6 as simple cyst,10 as solid mass. 43 showed single lesion and 1 multiple lesions. 44 hemangioblastomas were displayed on CT and MRI.The lesions located in cerebellar hemisphere (n=33), cerebellar vermis(n=8), brain stem(n=1),thoracic spinal cord (n=1),and both cerebellar hemisphere and cervical spinal cord (n=1).On contrast enhanced scans, all mural nodules and solid tumors showed marked homogeneous enhancement with a clear border. On PWI in 5 patients, the mural nodules (n=3) and solid tumors (n=2) demonstrated marked hyperperfusion. SRR ax and rCBV were (87.32±3.18)% and 704.68±46.74,respectively.The ratio of rCBV between hemangioblastoma and white matter was 13.79±0.99,and the difference of MTT between them was (0.99±0.39)s.Conclusion:Both CT and MRI can be used in the diagnosis of hemangioblastoma. MRI appeares more valuable than CT due to its ability in the demonstration of the mural nodule and flow void of the vessels. PWI may be of some value in differential diagnosis of hemangioblastoma.