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Concept of Enhancement in Brain Lesions-For the Beginners

Why do some tumours enhance and some don't?
Answer to this question lies in the concept of Blood brain barrier. The brain has a unique triple layered blood-brain barrier (BBB) with tight endothelial junctions in order to maintain a consistent internal homeostatis. Contrast will not leak into the brain unless this barrier is damaged. 

Enhancement is seen when a CNS tumor destroys the BBB. 

Extra-axial tumors such as meningiomas and schwannomas are not derived from brain cells and do not have a blood-brain barrier. Therefore they will enhance.  There is also no blood-brain barrier in the pituitary, pineal and choroid plexus regions as these are normally out of BBB.
Concept of Enhancement in Brain Lesions-For the Beginners Reviewed by Sumer Sethi on Thursday, January 05, 2012 Rating: 5

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