Abstract
Skull base lesions can be a diagnostic challenge due to the complex anatomy, technical challenges in magnetic resonance imaging of the region, the possibility of pseudotumors, and a wide variety of intrinsic bone lesions as well as head and neck pathology with extension into the skull base. Firstly some key points on the CT and MRI techniques used in clinical neuroradiology of the skull base region are addressed, followed by a brief discussion on what kind of information the surgeon expects to find in the radiology report. Secondly, the skull base lesions without a predilection site are reviewed, predominantly focusing on the most frequent pathology but also providing examples of some very rare tumors. Finally, an overview of the radiology of skull base tumors and pseudotumors is provided according to their common site of origin, focusing on typical clinical and imaging features.
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Abbreviations
- ABC:
-
Aneurysmal bone cyst
- ANCA:
-
Antineutrophil cytoplasmic antibodies
- ASB:
-
Anterior skull base
- CGCG:
-
Central giant-cell granuloma
- CPA:
-
Cerebellopontine angle
- CSB:
-
Central skull base
- CSF:
-
Cerebrospinal fluid
- CT:
-
Computed tomography
- DSC:
-
Dynamic susceptibility contrast
- DWI:
-
Diffusion-weighted imaging
- ELST:
-
Endolymphatic sac tumors
- EPI:
-
Echoplanar imaging
- GCT:
-
Giant-cell tumor
- Gd:
-
Gadolinium
- GRE:
-
Gradient echo
- JF:
-
Jugular foramen
- LEDS:
-
Large endolymphatic duct and sac
- LHC:
-
Langerhans cell histiocytosis
- MRA:
-
Magnetic resonance angiography
- MRI:
-
Magnetic resonance imaging
- PSB:
-
Posterior skull base
- SNHL:
-
Sensorineural hearing loss
- T1WI:
-
T1-weighted images
- T2WI:
-
T2-weighted images
- TOF:
-
Time of flight
- TSE:
-
Turbo spin echo
References
Badger D, Aygun N. Imaging of perineural spread in head and neck cancer. Radiol Clin N Am. 2017;55(1):139–49. https://doi.org/10.1016/j.rcl.2016.08.006.
Bonneville F, Savatovsky J, Chiras J. Imaging of cerebellopontine angle lesions: an update. Part 1. Enhancing extra-axial lesions. Eur Radiol. 2007a;17:2472–82. https://doi.org/10.1007/s00330-007-0679-x.
Bonneville F, Savatovsky J, Chiras J. Imaging of cerebellopontine angle lesions: an update. Part 2. Intra-axial lesions, skull base lesions that may invade the CPA region, and non-enhancing extra-axial lesions. Eur Radiol. 2007b;17:2908–20. https://doi.org/10.1007/s00330-007-0680-4.
Borges A. Skull base tumours. Part I: imaging technique, anatomy and anterior skull base tumours. Eur J Radiol. 2008a;66(3):338–47. https://doi.org/10.1016/j.ejrad.2008.01.017.
Borges A. Skull base tumours. Part II. Central skull base tumours and intrinsic tumours of the bony skull base. Eur J Radiol. 2008b;66(3):348–62. https://doi.org/10.1016/j.ejrad.2008.01.018.
Butman JA, Kim HJ, Baggenstos M, Ammerman JM, Dambrosia J, Patsalides A, Patronas NJ, Oldfield EH, Lonser RR. Mechanisms of morbid hearing loss associated with tumors of the endolymphatic sac in von Hippel-Lindau disease. JAMA. 2007;298(1):41–8. https://doi.org/10.1001/jama.298.1.41.
Casselman JW, De Jonge I, Neyt L, De Clercq C, D’Hont G. MRI in craniofacial fibrous dysplasia. Neuroradiology. 1993;35(3):234–7.
Chapman PR, Shah R, Curé JK, Bag AK. Petrous apex lesions: pictorial review. AJR Am J Roentgenol. 2011;196(3 Suppl):WS26-37. Quiz S40-3. https://doi.org/10.2214/AJR.10.7229.
Conley LM, Phillips CD. Imaging of the central skull base. Radiol Clin N Am. 2017;55(1):53–67. https://doi.org/10.1016/j.rcl.2016.08.007.
Connor SE. The skull base in the evaluation of sinonasal disease: role of computed tomography and MR imaging. Neuroimaging Clin N Am. 2015;25(4):619–51. https://doi.org/10.1016/j.nic.2015.07.007.
Fernández-Latorre F, Menor-Serrano F, Alonso-Charterina S, Arenas-Jiménez J. Langerhans’ cell histiocytosis of the temporal bone in pediatric patients: imaging and follow-up. AJR Am J Roentgenol. 2000;174(1):217–21. https://doi.org/10.2214/ajr.174.1.1740217.
Iida E, Anzai Y. Imaging of paranasal sinuses and anterior skull base and relevant anatomic variations. Radiol Clin N Am. 2017;55(1):31–52. https://doi.org/10.1016/j.rcl.2016.08.009.
Kadar AA, Hearst MJ, Collings MH, Mangano FT, Samy RN. Ewing’s sarcoma of the petrous temporal bone: case report and literature. Skull Base. 2010;20(3):213–7. https://doi.org/10.1055/s-0029-1246224.
Kim S, Jung DW, Pak MG, Song YJ, Bae WY. An aneurysmal bone cyst in the skull base. J Craniofac Surg. 2017;28(7):e704–6. https://doi.org/10.1097/SCS.0000000000003896.
Kimura F, Kim KS, Friedman H, Russell EJ, Breit R. MR imaging of the normal and abnormal clivus. AJR Am J Roentgenol. 1992;155:1285–91. https://doi.org/10.2214/ajr.155.6.2122682.
Laigle-Donadey F, Taillibert S, Martin-Duverneuil N, Hildebrand J, Delattre JY. Skull-base metastases. J Neuro-Oncol. 2005;75(1):63–9. https://doi.org/10.1007/s11060-004-8099-0.
Na’ara S, Amit M, Gil Z, Billan S. Plasmacytoma of the skull base: a meta-analysis. J Neurol Surg B Skull Base. 2016;77(1):61–5. https://doi.org/10.1055/s-0035-1560047.
Pakalniskis MG, Berg AD, Policeni BA, Gentry LR, Sato Y, Moritani T, Smoker WR. The many faces of granulomatosis with polyangiitis: a review of the head and neck imaging manifestations. AJR Am J Roentgenol. 2015;205(6):W619–29. https://doi.org/10.2214/AJR.14.13864.
Pesce A, Acqui M, Cimatti M, Caruso R, Wierzbicki V, Raco A. Primary lymphomas of the skull base from a neurosurgical perspective: review of the literature and personal experience. J Neurol Surg A Cent Eur Neurosurg. 2017;78(1):60–6. https://doi.org/10.1055/s-0035-1571160.
Rubin Grandis J, Branstetter BF 4th, Yu VL. The changing face of malignant (necrotising) external otitis: clinical, radiological, and anatomic correlations. Lancet Infect Dis. 2004 Jan;4(1):34–9.
Saw S, Thomas N, Gleeson MJ, Bódi I, Connor S, Hortobágyi T. Giant cell tumour and central giant cell reparative granuloma of the skull: do these represent ends of a spectrum? A case report and literature review. Pathol Oncol Res. 2009;15(2):291–5. https://doi.org/10.1007/s12253-008-9124-y.
Skolnik AD, Loevner LA, Sampathu DM, Newman JG, Lee JY, Bagley LJ, Learned KO. Cranial nerve Schwannomas: diagnostic imaging approach. Radiographics. 2016;36(5):1463–77. https://doi.org/10.1148/rg.2016150199.
Somers T, Casselman J, de Ceulaer G, Govaerts P, Offeciers E. Prognostic value of magnetic resonance imaging findings in hearing preservation surgery for vestibular schwannoma. Otol Neurotol. 2001;22(1):87–94. https://doi.org/10.1097/00129492-200101000-00017.
Thust SC, Yousry T. Imaging of skull base tumours. Rep Pract Oncol Radiother. 2016;21(4):304–18. https://doi.org/10.1016/j.rpor.2015.12.008.
VandeVyver V, Lemmerling M, De Foer B, Casselman J, Verstraete K. Arachnoid granulations of the posterior temporal bone wall: imaging appearance and differential diagnosis. AJNR Am J Neuroradiol. 2007;28(4):610–2.
Vogl TJ, Bisdas S. Differential diagnosis of jugular foramen lesions. Skull Base. 2009;19(1):3–16. https://doi.org/10.1055/s-0028-1103121.
Further Reading
Aygun N, Miller F. Skull base imaging. Philadelphia: Elsevier; 2017.
Chong V. Skull base imaging. 1st ed. Philadelphia: Elsevier; 2018.
Kelly HR, Casselman JW, Cunnane MB, Curtin HD. Chapter 16 Skull base. In: Atlas SW, editor. Magnetic resonance imaging of the brain and spine. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2017.
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Casselman, J.W., Vanden Bossche, S., Pretorius, E., De Foer, B. (2019). Skull-Base Tumors and Related Disorders. In: Barkhof, F., Jager, R., Thurnher, M., Rovira Cañellas, A. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-61423-6_60-1
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