Glioma MRI

Glioma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Glioma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Glioma MRI On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Glioma MRI All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Glioma MRI
CDC on Glioma MRI
Glioma MRI in the news
Blogs on Glioma MRI
Directions to Hospitals Treating Glioma
Risk calculators and risk factors for Glioma MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Sujit Routray, M.D. [3]

Overview

Brain MRI may be diagnostic of glioma.

MRI

Brain MRI may be diagnostic of glioma.

Type of glioma	CT findings
Pilocytic astrocytoma	1. T1: Iso- to hypointense solid component 2. T2: Hyperintense solid component
Low-grade astrocytoma	1. T1: Isointense to hypointense Confined to the white matter and causes expansion of the adjacent cortex 2. T2/FLAIR: Mass-like hyperintense signals Confined to the white matter and causes expansion of the adjacent cortex Cortex can also be involved in late cases in comparison to the oligodendroglioma, which is a cortical based tumor from the start Microcystic changes along the line of spread High T2 signal (not related to cellularity or cellular atypia, but rather edema, demyelination, and other degenerative changes) 3. DWI: No restricted diffusion Increased diffusibility 4. T1 C+ (Gd): No enhancement 5. MR spectroscopy: Tumor will show elevated choline peak, low NAA peak, elevated choline:creatine ratio Lack of the lactate peak 6. MR perfusion: No elevation of rCBV
Anaplastic astrocytoma	1. T1: Hypointense 2. T2: Hyperintense but can be heterogeneous, if calcification of blood present 3. T1 C+ (Gd): Variable enhancement Presence of ring enhancement suggests central necrosis 4. MR spectroscopy Increased choline:creatine ratio NAA preserved or mildly depressed No significant lactate Intermediate levels of myo-inositol (lower than low grade, higher than glioblastoma) 5. MR perfusion: Elevated cerebral blood volume
Glioblastoma multiforme	1. Irregular thick margins: iso- to slightly hyperattenuating (high cellularity) 2. Irregular hypodense centre representing necrosis 3. Marked mass effect 4. Surrounding vasogenic edema 5. Hemorrhage 6. Calcification is rare
Oligodendroglioma	1. Hypodense to isodense 2. Calcification (70-90%) 3. Hemorrhage 4. Overlying skull may show pressure erosion
Ependymoma	1. Coarse calcification is common (50%) 2. Cystic areas (50%) 3. Iso- to hypodense solid component 4. Heterogeneous enhancement 5. Hemorrhage

Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

• 
• 

• 
• 

References

Template:WikiDoc Sources