Evaluation of Skull Base Tumors with Dynamic TurboFLASH MRI during Gadolinium Injection

Abstract Background and Purpose This study was aimed to investigate the role of dynamic TurboFLASH gadolinium (Gd) magnetic resonance (MR) imaging in improving the differential diagnosis of skull base tumors. Methods Eleven patients with skull base tumors underwent standard MR and ultrafast TurboFLASH sequence during gadolinium injection. Results The characterization of tumor vascularity was performed. Different patterns of gadolinium uptake for each tumor type were observed. This is particularly important to identify tumors at high risk of intraoperative bleeding. All glomus tumors, typically highly vascularized, showed an enhancement at the arterial phase, reflecting the arterialization of these tumors which is not detectable on conventional MR. No signal increase at the arterial phase was instead observed in other cases in which the ruling out of a glomus tumor was important because of the location of the lesion. Moreover TurboFLASH identified the pathognomonic “filling-in” profile of cavernous sinus cavernous hemangiomas (CSCH), that is, the progressive centripetal enhancement of the lesion at the beginning of the venous phase. Conclusion The dynamic analysis of tumor contrast enhancement with the TurboFLASH sequence provides useful additional information to that obtained with conventional MR, improving the differential diagnosis of skull base tumors, particularly in the distinction between glomus and nonglomus tumors and in diagnosing CSCH.

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Work productivity and neuropsychological function in persons with skull base tumors

Neuro-Oncology Practice ◽

10.1093/nop/npu015 ◽

2014 ◽

Vol 1 (3) ◽

pp. 106-113 ◽

Cited By ~ 5

Author(s):

Bethany D. Nugent ◽

Jason Weimer ◽

Chienwen J. Choi ◽

Cathy J. Bradley ◽

Catherine M. Bender ◽

...

Keyword(s):

Depressive Symptoms ◽

Skull Base ◽

Surgical Intervention ◽

Work Productivity ◽

Physical Work ◽

Tumor Type ◽

Neuropsychological Function ◽

Work Demands ◽

Skull Base Tumors ◽

The Impact

Abstract Background Skull base tumors comprise many common benign brain tumors. Treatment has advanced, allowing many survivors to return to work. However, literature is limited about the neuropsychological status of these patients prior to treatment. Literature pertaining to the relationship between neuropsychological functioning and occupational ability prior to surgical intervention is even more limited. The purpose of this analysis was to evaluate the impact of neuropsychological function on work productivity in persons with skull base tumors prior to resection. Methods Neuropsychological function and work productivity were assessed in adults newly diagnosed with skull base tumors (n = 45) prior to surgical intervention. Univariate analyses identified potential predictors of work limitations; variables with P < .10 were analyzed using multivariate regression analyses controlled for age, sex, tumor type, and education. Results Poorer mental attention and flexibility (MF) and higher depressive symptoms (DS) were significantly associated with poor time management at work (MF: β = -0.59, P = .01; DS: β = 3.42, P < .01; R2 = 0.54). Difficulty meeting physical work demands was significantly associated with poorer visuospatial ability (VA) and higher depressive symptoms (VA: β = −3.30, P = .05; DS: β = 2.29, P < .01; R2 = 0.29). Lower learning and memory scores (LM) and higher depressive symptoms were significantly associated with difficulty meeting mental-interpersonal work demands (LM: β = −3.39, P = .04; DS: β = 3.25, P < .01; R2 = 0.47) and overall health-related loss of work productivity (LM: β = −0.72, P = .05; DS: β = 0.659, P < .001; R2 = 0.43). Conclusion Domains of neuropsychological function that predicted work productivity were identified. Future research should examine neuropsychological function, depressive symptoms, and work productivity across the care trajectory from diagnosis through long-term survivorship.

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