Fig. 15

Internal architecture of a high-grade tumour. A 2-year-old child with headache, vomiting and right hemiparesis. a CT demonstrates a large heterogeneous left frontal tumour with calcified foci. b T2-weighted image: the mass is irregularly hyperintense with cystic changes and small hypointensities representing small vessels and calcifications. c Post-contrast T1-weighted image shows patchy enhancement of the lateral part of the lesion and some vascular structures. d CE-SWI minIP: calcifications appear as punctate hypointensities, unchanged after gadolinium injection (white arrows). Post-processing with minIP algorithm allows the simultaneous visualisation of arteries (hyperintense, black arrows) and veins (linear hypointensities, open arrow) around and inside the tumour. CE-SWI is superior to T1-weighted post-gadolinium sequences in demonstrating a diffuse BBB rupture in the lateral necrotic area (bright signal, asterisk). Histopathology revealed a primary neuroectodermal tumour (PNET) with extensive cystic and necrotic changes and increased vascularity