MRI characteristics of intracranial masses in the paediatric population of KwaZulu-Natal: A neuroimaging-based study (original) (raw)

South African Journal of Radiology

Intracranial infections are a major burden in LMICs because of poverty, overcrowding, inadequate access to clean water and proper sanitation systems, and insufficient access to healthcare. In a recent meta-analysis study by Robertson et al., sub-Saharan Africa had the highest rates of bacterial meningitis, neurocysticercosis and tuberculosis-related disease, with an incidence of 65 to 650 per 100 000. This is in contrast to high-income countries, with an incidence ranging from 0.56 to 2 per 100 000. 7 The clinical symptoms and signs of intracranial masses should never be underestimated, no matter how subtle, as they are clues that assist the clinicians in performing appropriate radiological investigations. Background: MRI is the imaging modality of choice for the assessment of intracranial masses in children. Imaging is vital in planning further management. Objectives: The purpose of this study was to describe the common intracranial masses and their imaging characteristics in the paediatric population referred to Inkosi Albert Luthuli Central Hospital for MRI of the brain. Method: We retrospectively reviewed the medical records of paediatric patients (aged from birth to 18 years) who underwent MRI investigations for intracranial masses between January 2010 and December 2016. Results: A total of 931 MRI brain scans were performed. One hundred and seven scans met the inclusion criteria, of which 92 were primary brain tumours and 15 were inflammatory masses. The majority were females (56%). The mean age was 12 ± 4.52 (range of 3-18 years). The most common presenting symptom was seizures (70/107, 65.4%). We categorised the masses according to supra-and infratentorial compartments. The most common site for masses was the supratentorial compartment (n = 56, 52%). The most common masses in the supratentorial compartment were craniopharyngiomas (14/45, 31.1%), whilst in the infratentorial compartment, the most common masses were medulloblastomas (24/47, 51.1%). Conclusion: In our series, the supratentorial compartment was the commonest site for intracranial masses. The most common tumour in the infratentorial compartment was medulloblastoma. This information is vital in formulating differential diagnoses of intracranial masses.