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CT Scan

  • Prior to contrast administration, the tumor is predominantly isodense midline posterior fossa mass with variable enhancement.
  • Cyst formation is common and readily visible on CT.
  • Calcifications appear in 44% of cases, and are either diffuse or coarsely nodular.


MRI scan

  • Signal intensity is the same in ependymoma as other intracranial gliomas.
  • MR defines the location and gross morphology of the tumor.
  • It is important to accurately define the caudal extent of the tumor (for the purposes of resection and subsequent radiotherapy).
  • Ependymomas appear hypointense on T1-weighted images, hyperintense on T2-weighted images, and usually enhance with gadolinium.
  • Ependymomas present as a nonspecific heterogenous signal. This heterogeneity in imaging studies can reflect cystic regions, areas of necrosis, hemorrhage, and calcification.
  • Gadolinium contrast enhancement occurs in nearly all ependymomas.


The MR (T1 weighted) below shows a midline posterior fossa ependymoma. #1 points to the tumor.


Below is a more extensive tumor arising again in the mid line.



While CT and MRI can give a probable diagnosis, the final diagnosis cannot be made without tissue sampling.




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