Quattrocchi CC, Errante Y, Rossi Espagnet MC, Galassi S, Della Sala SW, Bernardi B, Fariello G, Longo D. Magnetic resonance imaging differential diagnosis of brainstem lesions in children. World J Radiol 2016; 8(1): 1-20 [PMID: 26834941 DOI: 10.4329/wjr.v8.i1.1]
Corresponding Author of This Article
Carlo Cosimo Quattrocchi, MD, PhD, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, via Alvaro del Portillo, 00128 Rome, Italy. c.quattrocchi@unicampus.it
Research Domain of This Article
Neuroimaging
Article-Type of This Article
Diagnosis Advances
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Jan 28, 2016; 8(1): 1-20 Published online Jan 28, 2016. doi: 10.4329/wjr.v8.i1.1
Magnetic resonance imaging differential diagnosis of brainstem lesions in children
Carlo Cosimo Quattrocchi, Yuri Errante, Maria Camilla Rossi Espagnet, Stefania Galassi, Sabino Walter Della Sala, Bruno Bernardi, Giuseppe Fariello, Daniela Longo
Carlo Cosimo Quattrocchi, Yuri Errante, Sabino Walter Della Sala, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
Maria Camilla Rossi Espagnet, Department of NESMOS, Sant’Andrea Hospital, Università La Sapienza, 00189 Rome, Italy
Stefania Galassi, Bruno Bernardi, Daniela Longo, Unit of Neuroradiology, Bambino Gesù Children’s Research Hospital IRCCS, 00165 Rome, Italy
Giuseppe Fariello, Fatebenefratelli S. Pietro Hospital, 00189 Rome, Italy
Author contributions: Quattrocchi CC conceived and designed the study and wrote the manuscript; Errante Y collected references and wrote the manuscript; Rossi Espagnet MC and Galassi S collected diagnostic images and references; Della Sala SW, Bernardi B and Fariello G critically revised the manuscript for important intellectual content; Longo D supervised the study, collected diagnostic images and references and critically revised the manuscript for important intellectual content.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carlo Cosimo Quattrocchi, MD, PhD, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, via Alvaro del Portillo, 00128 Rome, Italy. c.quattrocchi@unicampus.it
Telephone: +39-062-25411708
Received: August 31, 2015 Peer-review started: September 1, 2015 First decision: September 29, 2015 Revised: October 11, 2015 Accepted: December 9, 2015 Article in press: December 11, 2015 Published online: January 28, 2016
Abstract
Differential diagnosis of brainstem lesions, either isolated or in association with cerebellar and supra-tentorial lesions, can be challenging. Knowledge of the structural organization is crucial for the differential diagnosis and establishment of prognosis of pathologies with involvement of the brainstem. Familiarity with the location of the lesions in the brainstem is essential, especially in the pediatric population. Magnetic resonance imaging (MRI) is the most sensitive and specific imaging technique for diagnosing disorders of the posterior fossa and, particularly, the brainstem. High magnetic static field MRI allows detailed visualization of the morphology, signal intensity and metabolic content of the brainstem nuclei, together with visualization of the normal development and myelination. In this pictorial essay we review the brainstem pathology in pediatric patients and consider the MR imaging patterns that may help the radiologist to differentiate among vascular, toxico-metabolic, infective-inflammatory, degenerative and neoplastic processes. Helpful MR tips can guide the differential diagnosis: These include the location and morphology of lesions, the brainstem vascularization territories, gray and white matter distribution and tissue selective vulnerability.
Core tip: Magnetic resonance imaging differential diagnosis of brainstem lesions in children is depicted with an anatomical-based pictorial essay approach.
