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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:94-97, January 2006
© 2006 American Society of Neuroradiology

CASE REPORT
BRAIN

Perfusion MR Imaging of an Intracranial Collision Tumor Confirmed by Image-Guided Biopsy

P. Jun^a, J. Garcia^b, T. Tihan^b, M.W. McDermott^c and S. Cha^a,c

^a Department of Radiology, University of California, San Francisco, Calif
^b Department of Pathology, University of California, San Francisco, Calif
^c Department of Neurological Surgery, University of California, San Francisco, Calif

Address correspondence to: Soonmee Cha, MD, Department of Radiology and Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave, Box 0628, Room L358, San Francisco, CA 94143

SUMMARY: We present a patient with a new intracranial mass lesion that was initially interpreted as a metastasis on conventional anatomic MR imaging. On dynamic, contrast-enhanced, susceptibility-weighted perfusion MR imaging, however, there were regional hemodynamic differences within the lesion. Image-guided open biopsy targeting these regions uncovered a collision tumor between a typical meningioma and a metastatic breast carcinoma. In cases where conventional anatomic MR imaging is ambiguous, physiology-based neuroimaging methods provide complementary physiologic information useful for discriminating between histologically unique tissue types.