The presence of intracranial adipose tissue is often overlooked, although it may be detected in different physiological (dural sinuses or falx deposition of fat) and pathological (lipoma, dermoid cyst, subarachnoid fat dissemination) conditions. In this review, we illustrate various scenarios in which radiologists and neuroradiologists may encounter intracranial fat, providing a list of differential diagnosis.

Imaging of intracranial fat: from normal findings to pathology.

Three-dimensional constructive interference in steady state (3D CISS) is a steady-state gradient-echo sequence in magnetic resonance imaging (MRI) that has been used in an increasing number of applications in the study of brain disease in recent years. Owing to the very high spatial resolution, the strong hyperintensity of the cerebrospinal fluid signal and the high contrast-to-noise ratio, 3D CISS can be employed in a wide range of scenarios, ranging from the traditional study of cranial nerves, the ventricular system, the subarachnoid cisterns and related pathology to more recently discussed applications, such as the fundamental role it can assume in the setting of acute ischemic stroke, vascular malformations, infections and several brain tumors. In this review, after briefly summarizing its fundamental physical principles, we examine in detail the various applications of 3D CISS in brain imaging, providing numerous representative cases, so as to help radiologists improve its use in imaging protocols in daily clinical practice.

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Three-Dimensional Constructive Interference in Steady State (3D CISS) Imaging and Clinical Applications in Brain Pathology

department for evaluation of right hypoacousia. Unenhanced Computed Tomography (CT) of the temporal bones showed a 15 mm hypodense mass infiltrating the right cerebellopontine angle (CPA) and the internal auditory canal (IAC) (arrows, Figure 1A). This mass showed negative Hounsfield Unit (HU) values in keeping with fatty content. Vestibulo-cochlear malformations were also found, including a hypoplastic lateral semi-circular canal (arrows, Figure 1B) and a globular aspect of the cochlea with an underdeveloped third turn (not shown). Magnetic Resonance Imaging (MRI) performed for better evaluation showed homogeneous high T1 signal of the lesion with signal drop on fat-saturated sequence, thus confirming the fatty composition of the mass (curved arrows, Figure 2B). Gombert, M and Mailleux, P. Cerebellopontine Angle Lipoma Associated to Dysplastic Labyrinth. Journal of the Belgian Society of Radiology. 2018; 102(1): 43, pp. 1–2. DOI: https://doi.org/10.5334/jbsr.1472

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Martin Gombert

Papers

Cerebellopontine Angle Lipoma Associated to Dysplastic Labyrinth