Many primary brain tumors and metastases can bleed [34, 73-78]. The signal intensity of intra-tu-
moral hemorrhage (Fig. 6.8) tends to be more complex and its evolution tends to be delayed when compared with non-neoplastic hemorrhages [34,78]. DW and b0 images are useful to detect the hemorrhage in tumors .
Hemorrhagic tumor.The T2-weighted MR image (a) in a 54-year-old woman with glioblastoma shows a mass lesion with heterogeneous intensity near the right lateral ventricle.The irregular hypointensities centrally in the lesion (arrow) indicate hemorrhage.The T1-weighted image (b) shows the heterogeneous hypointense to isointense mass, with a central area of higher signal intensity consistent with hemorrhage (arrow). The gadolinium-enhanced Tl-weighted image (c) shows heterogeneous enhancement (arrow). On the DW image (d) the hemorrhage is heterogeneously hypointense (arrow).The b0 image (e) shows the hemorrhage to be more hypointense (arrow) than on the T2-weighted image (a).The ADC (f) cannot be calculated due to magnetic susceptibility artifacts
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