Brain Stem Gliomas MRI: Difference between revisions
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==Overview== | ==Overview== | ||
On MRI brain, diffuse brainstem glioma is characterized by decreased intensity on T1, heterogenously increased on T2. Focal brainstem glioma is characterized by iso- to hypointense to grey matter on T1, and hyperintense to grey matter on T2. | |||
==MRI== | ==MRI== | ||
MRI is the imaging modality of choice for brainstem gliomas. The findings will vary with the tumor type.<ref>Imaging of Brainstem gliomas. Dr Yuranga Weerakkody and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/brainstem-glioma</ref> | MRI brain is the imaging modality of choice for brainstem gliomas. The findings will vary with the tumor type.<ref>Imaging of Brainstem gliomas. Dr Yuranga Weerakkody and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/brainstem-glioma</ref> | ||
'''Diffuse brainstem gliomas''' | '''Diffuse brainstem gliomas''' | ||
The pons is enlarged, with the basilar artery displaced anteriorly against the clivus and potentially engulfed. The floor of the fourth ventricle is flattened ("flat floor of fourth ventricle sign") and [[obstructive hydrocephalus]] may be present. Occasionally the tumor is exophytic, either outwards into the basal cisterns or centrally in the | The pons is enlarged, with the basilar artery displaced anteriorly against the clivus and potentially engulfed. The floor of the [[fourth ventricle]] is flattened ("flat floor of fourth ventricle sign") and [[obstructive hydrocephalus]] may be present. Occasionally the tumor is exophytic, either outwards into the basal cisterns or centrally in the fourth ventricle. Usually the tumor is homogenous pre-treatment, however in a minority of patients areas of [[necrosis]] may be present. | ||
:*'''T1''': Decreased intensity | :*'''T1''': Decreased intensity | ||
:*'''T2''': Heterogeneously increased | :*'''T2''': Heterogeneously increased | ||
:*'''T1 C+ (Gd)''': Usually minimal (can enhance post radiotherapy) | :*'''T1 C+ (Gd)''': Usually minimal (can enhance post [[radiotherapy]]) | ||
:*'''Diffusion weighted imaging (DWI)''': Usually normal, occasionally mildly restricted | :*'''Diffusion weighted imaging (DWI)''': Usually normal, occasionally mildly restricted | ||
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Typically the tumors demonstrate expansion of the tectal plate by a solid nodule of tissue. | Typically the tumors demonstrate expansion of the tectal plate by a solid nodule of tissue. | ||
:*'''T1''': Iso- to slightly hypointense to grey matter | :*'''T1''': Iso- to slightly hypointense to grey matter | ||
:*'''T2''': Hyperintense to grey matter | :*'''T2''': Hyperintense to [[grey matter]] | ||
:*'''T1 C+ (Gd)''': Usually no enhancement | :*'''T1 C+ (Gd)''': Usually no enhancement | ||
With time the mass can develop small cystic spaces (sometimes associated with neurological deficits) or calcification. Higher grade tumors tend to be larger and tend to enhance more vividly. | With time the mass can develop small cystic spaces (sometimes associated with neurological deficits) or [[calcification]]. Higher grade tumors tend to be larger and tend to enhance more vividly. | ||
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[[Category:Medicine]] | |||
[[Category:Neurology]] | |||
[[Category:Neurosurgery]] | |||
Latest revision as of 02:32, 6 November 2017
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Brain Stem Gliomas Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Brain Stem Gliomas MRI On the Web |
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American Roentgen Ray Society Images of Brain Stem Gliomas MRI |
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Risk calculators and risk factors for Brain Stem Gliomas MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
On MRI brain, diffuse brainstem glioma is characterized by decreased intensity on T1, heterogenously increased on T2. Focal brainstem glioma is characterized by iso- to hypointense to grey matter on T1, and hyperintense to grey matter on T2.
MRI
MRI brain is the imaging modality of choice for brainstem gliomas. The findings will vary with the tumor type.[1]
Diffuse brainstem gliomas
The pons is enlarged, with the basilar artery displaced anteriorly against the clivus and potentially engulfed. The floor of the fourth ventricle is flattened ("flat floor of fourth ventricle sign") and obstructive hydrocephalus may be present. Occasionally the tumor is exophytic, either outwards into the basal cisterns or centrally in the fourth ventricle. Usually the tumor is homogenous pre-treatment, however in a minority of patients areas of necrosis may be present.
- T1: Decreased intensity
- T2: Heterogeneously increased
- T1 C+ (Gd): Usually minimal (can enhance post radiotherapy)
- Diffusion weighted imaging (DWI): Usually normal, occasionally mildly restricted
Focal brainstem glioma
- Tectal glioma subtype
Typically the tumors demonstrate expansion of the tectal plate by a solid nodule of tissue.
- T1: Iso- to slightly hypointense to grey matter
- T2: Hyperintense to grey matter
- T1 C+ (Gd): Usually no enhancement
With time the mass can develop small cystic spaces (sometimes associated with neurological deficits) or calcification. Higher grade tumors tend to be larger and tend to enhance more vividly.
References
- ↑ Imaging of Brainstem gliomas. Dr Yuranga Weerakkody and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/brainstem-glioma