Glioma MRI: Difference between revisions

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Revision as of 19:05, 22 September 2015

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.^[1]^[2]^[3]^[4]^[5]^[6]

MRI

Brain MRI may be diagnostic of glioma.^[1]^[2]^[3]^[4]^[5]^[6]


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. Variable enhancement 2. Regions of low attenuation 3. Positive mass effect
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

↑ ^1.0 ^1.1 Radiological findings of pilocytic astrocytoma. Radiopaedia.org 2015. http://radiopaedia.org/articles/pilocytic-astrocytoma
↑ ^2.0 ^2.1 Radiological findings of low grade infiltrative astrocytoma. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma
↑ ^3.0 ^3.1 Radiological findings of anaplastic astrocytoma. http://radiopaedia.org/articles/anaplastic-astrocytoma
↑ ^4.0 ^4.1 Radiological findings of glioblastoma. http://radiopaedia.org/articles/glioblastoma
↑ ^5.0 ^5.1 Radiological findings of oligodendroglioma. http://radiopaedia.org/articles/oligodendroglioma
↑ ^6.0 ^6.1 Radiological findings of ependymoma. Radiopaedia.org 2015. http://radiopaedia.org/articles/ependymoma

Template:WikiDoc Sources

[aaa-1] 1.0 ^1.1 Radiological findings of pilocytic astrocytoma. Radiopaedia.org 2015. http://radiopaedia.org/articles/pilocytic-astrocytoma

[bbb-2] 2.0 ^2.1 Radiological findings of low grade infiltrative astrocytoma. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma

[ccc-3] 3.0 ^3.1 Radiological findings of anaplastic astrocytoma. http://radiopaedia.org/articles/anaplastic-astrocytoma

[ddd-4] 4.0 ^4.1 Radiological findings of glioblastoma. http://radiopaedia.org/articles/glioblastoma

[eee-5] 5.0 ^5.1 Radiological findings of oligodendroglioma. http://radiopaedia.org/articles/oligodendroglioma

[fff-6] 6.0 ^6.1 Radiological findings of ependymoma. Radiopaedia.org 2015. http://radiopaedia.org/articles/ependymoma

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@@ Line 6: / Line 6: @@
 ==Overview==
 [[Brain]] MRI may be diagnostic of glioma.<ref name=aaa>Radiological findings of pilocytic astrocytoma. Radiopaedia.org 2015. http://radiopaedia.org/articles/pilocytic-astrocytoma</ref><ref name=bbb>Radiological findings of low grade infiltrative astrocytoma. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma</ref><ref name=ccc>Radiological findings of anaplastic astrocytoma. http://radiopaedia.org/articles/anaplastic-astrocytoma</ref><ref name=ddd>Radiological findings of glioblastoma. http://radiopaedia.org/articles/glioblastoma</ref><ref name=eee>Radiological findings of oligodendroglioma. http://radiopaedia.org/articles/oligodendroglioma</ref><ref name=fff>Radiological findings of ependymoma. Radiopaedia.org 2015. http://radiopaedia.org/articles/ependymoma</ref>
 ==MRI==
 [[Brain]] MRI may be diagnostic of glioma.<ref name=aaa>Radiological findings of pilocytic astrocytoma. Radiopaedia.org 2015. http://radiopaedia.org/articles/pilocytic-astrocytoma</ref><ref name=bbb>Radiological findings of low grade infiltrative astrocytoma. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma</ref><ref name=ccc>Radiological findings of anaplastic astrocytoma. http://radiopaedia.org/articles/anaplastic-astrocytoma</ref><ref name=ddd>Radiological findings of glioblastoma. http://radiopaedia.org/articles/glioblastoma</ref><ref name=eee>Radiological findings of oligodendroglioma. http://radiopaedia.org/articles/oligodendroglioma</ref><ref name=fff>Radiological findings of ependymoma. Radiopaedia.org 2015. http://radiopaedia.org/articles/ependymoma</ref>
+{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
+|valign=top|
+|+
+! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Type of glioma}}
+! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|CT findings}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
+[[Pilocytic astrocytoma]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+:1. T1: iso- to hypointense solid component
+:2. T2: hyperintense solid component
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+[[Astrocytoma|Low-grade astrocytoma]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+: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
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+[[Astrocytoma|Anaplastic astrocytoma]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+:1. Variable enhancement
+:2. Regions of low attenuation
+:3. Positive mass effect
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+[[Glioblastoma multiforme]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+: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
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+[[Oligodendroglioma]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+:1. Hypodense to isodense
+:2. [[Calcification]] (70-90%)
+:3. [[Hemorrhage]]
+:4. Overlying skull may show pressure erosion
+|-
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
+[[Ependymoma]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+:1. Coarse [[calcification]] is common (50%)
+:2. Cystic areas (50%)
+:3. Iso- to hypodense solid component
+:4. Heterogeneous enhancement
+:5. [[Hemorrhage]]
+|}

Glioma MRI: Difference between revisions

Revision as of 19:05, 22 September 2015

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