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The use of CT and MRI in the characterization of intracranial mass lesions

Department of Neuroradiology, West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK

• Clinical and demographic information should be combined with imaging findings to arrive at a specific diagnosis or a short differential diagnosis.
  
• The age of the patient and anatomical location of the lesion(s) are the most useful discriminating factors.
  
• Intravenous administration of contrast material is indicated when an intracranial mass lesion is detected on CT or MRI.
  
• MRI is the preferred imaging modality for the evaluation of intracranial mass lesions, but CT is often performed at the initial presentation for practical reasons.
  

Intracranial mass lesions are an important cause of neurological morbidity and a common indication for cranial imaging. Given the wide range of pathological processes that can present as intracranial mass lesions, the radiologist has an important role in limiting the differential diagnosis in an individual case in order to inform the clinical decision-making process. This review illustrates the use of cranial CT and MRI, including diffusion weighted imaging (DWI), in the characterization of intracranial mass lesions. A detailed description of the imaging appearances of all mass lesions is beyond the scope of this review, but we hope to provide the reader with a rational approach to the complex task of producing a short differential diagnosis.