MRI Evaluation of Different Types of Cerebral Metastases

Abstract

Background: Cerebral metastases represent the most common intracranial tumors in adults and are associated with significant morbidity and mortality. Magnetic Resonance Imaging (MRI) is the imaging modality of choice for detection, characterization, and evaluation of brain metastases due to its superior soft-tissue contrast and multiparametric capabilities. Aim: To evaluate the MRI characteristics of different types of cerebral metastases and correlate their imaging features with the primary tumor origin. Materials and Methods: This retrospective descriptive case series included six patients with histopathologically or PET-CT–confirmed primary malignancies and radiologically diagnosed cerebral metastases. All patients underwent brain MRI, including conventional sequences, diffusionweighted imaging, susceptibility-weighted imaging, and MR spectroscopy where applicable. Imaging features such as lesion location, signal characteristics, enhancement patterns, diffusion restriction, hemorrhage, necrosis, and perilesional edema were analyzed. Results: Cerebral metastases demonstrated variable MRI appearances depending on the primary tumor. Lung carcinoma metastases commonly showed cystic lesions with ring enhancement and disproportionate perilesional edema. Hemorrhagic metastases were identified on SWI, particularly in metabolically active lesions. Rare metastatic patterns, such as those from salivary gland tumors, showed extensive multifocal involvement. Diagnostic challenges were encountered in differentiating metastases from primary brain tumors and vascular lesions, especially in cases with mixed solidcystic components. Conclusion: MRI provides critical diagnostic information in the evaluation of cerebral metastases. Recognition of characteristic imaging patterns and their correlation with primary malignancies can improve diagnostic accuracy, aid in differentiation from primary brain tumors, and guide appropriate patient management.