Oligodendroglioma MRI: Difference between revisions

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==Overview==
==Overview==
Brain MRI is helpful in the diagnosis of oligodendroglioma. On brain MRI, oligodendroglioma is characterized by a mass which is typically hypointense on T1-weighted images and hyperintense on T2-weighted images. [[Calcification]] is observed on T2 decay component of MRI.
Brain MRI is helpful in the diagnosis of oligodendroglioma. On brain MRI, oligodendroglioma is characterized by a mass which is typically hypointense on T1-weighted images and hyperintense on T2-weighted images. [[Calcification]] is observed as areas of "blooming" on T2 decay component of MRI.


==MRI==
==MRI==
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* Threshold of 1.75, rCBV above this threshold demonstrate more rapid tumor progression
* Threshold of 1.75, rCBV above this threshold demonstrate more rapid tumor progression
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[[File:Oligodendroglioma - anaplastic - haemorrhagic MRI axial DWI.jpg|thumb|200px|none| A left frontal lobe mass with central haemorrhagic component is present (intrinsic high T1, low T2) with a peripheral region of enhancement and high T2 signal. Some of the enhancement may be in reaction to the haemorrhage, depending on the time course.[http://radiopaedia.org/articles/oligodendroglioma Source: Dr. Henry Knipe and Dr. Frank Gaillard et al. Radiopaedia]]]
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[[File:Anaplastic oligoastrocytoma MRI T2.jpg|thumb|200px|none| MRI including post contrast sequences demonstrates a large mass involving the majority of the left frontal lobe, which exerts significant mass effect resulting in midline shift and effacement of the frontal horn of the lateral ventricle. The mass is heterogeneous, but predominantly hyperintense on T2 with a surrounding mantle of tumor edema. Following contrast there is heterogeneous moderate enhancement.[http://radiopaedia.org/cases/anaplastic-oligoastrocytoma Source: Dr. Frank Gaillard. Radiopaedia]]]
[[File:Anaplastic oligoastrocytoma MRI T2.jpg|thumb|200px|none| MRI including post contrast sequences demonstrates a large mass involving the majority of the left frontal lobe, which exerts significant mass effect resulting in midline shift and effacement of the frontal horn of the lateral ventricle. The mass is heterogeneous, but predominantly hyperintense on T2 with a surrounding mantle of tumor edema. Following contrast there is heterogeneous moderate enhancement.[http://radiopaedia.org/cases/anaplastic-oligoastrocytoma Source: Dr. Frank Gaillard. Radiopaedia]]]
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[[File:Oligodendroglioma - anaplastic - haemorrhagic MRI axial DWI.jpg|thumb|200px|none| A left frontal lobe mass with central haemorrhagic component is present (intrinsic high T1, low T2) with a peripheral region of enhancement and high T2 signal. Some of the enhancement may be in reaction to the haemorrhage, depending on the time course.[http://radiopaedia.org/articles/oligodendroglioma Source: Dr. Henry Knipe and Dr. Frank Gaillard et al. Radiopaedia]]]
 
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Revision as of 22:03, 15 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Sujit Routray, M.D. [3]

Overview

Brain MRI is helpful in the diagnosis of oligodendroglioma. On brain MRI, oligodendroglioma is characterized by a mass which is typically hypointense on T1-weighted images and hyperintense on T2-weighted images. Calcification is observed as areas of "blooming" on T2 decay component of MRI.

MRI

  • Brain MRI may be helpful in the diagnosis of oligodendroglioma
  • Findings on MRI suggestive of oligodendroglioma are listed below:[1][2][3][4][5]
MRI component Findings

T1

  • Typically hypointense

T2

  • Typically hyperintense (except calcified areas)
  • Enlargement of the lateral ventricles and the third ventricle with periventricular high intensity signal suggestive of transependymal absorption or tumor spreading

T2 decay

T1 C + gadolinium

  • Heterogeneous contrast enhancement
  • Not a reliable indicator of tumor grade
  • Only 50% of oligodendrogliomas enhance to a variable degree

Diffusion weighted images (DWI)

  • Typically no diffusion restriction
  • Helps differentiate lower grade oligodendrogliomas from higher grade astrocytomas:
    • Astrocytomas have higher ADC values because of:
      • Lower cellularity
      • Greater hyaluronan proportion

MR perfusion (PWI)

  • Generally 95% sensitive for diagnosis of oligodendrogliomas
  • Increased vascularity
  • "Chicken wire" network of vascularity results in elevated relative cerebral blood volume (rCBV) of grade II vs grade III on PWI
  • 87% sensitivity for distinguishing grade II from grade III oligodendrogliomas
  • Threshold of 1.75, rCBV above this threshold demonstrate more rapid tumor progression
A left frontal lobe mass with central haemorrhagic component is present (intrinsic high T1, low T2) with a peripheral region of enhancement and high T2 signal. Some of the enhancement may be in reaction to the haemorrhage, depending on the time course.Source: Dr. Henry Knipe and Dr. Frank Gaillard et al. Radiopaedia
A sharply defined zone of abnormal slightly heterogeneous signal in the left parietal lobe extends to involve the medial cortex of the superior parietal lobule. Inferiorly it abuts and distorts the cingulate gyrus. Superiorly it is significantly posterior to the precentral gyrus and slightly posterior to the left post central gyrus. Posterior and laterally it extends to and distorts the left intraparietal sulcus. It extends to within 1 cm of the parieto-occipital fissure postero-medially, slightly posteriorly bowing it. It exhibits no restricted diffusion and no pathological contrast enhancement.Source: Dr. Henry Knipe and Dr. Frank Gaillard et al. Radiopaedia
MRI axial FLAIR showing a relatively well circumscribed mass involving the temporal lobe and insular cortex, without convincing enhancement, and minimal restricted diffusion Source: Dr. Frank Gaillard. Radiopaedia
MRI including post contrast sequences demonstrates a large mass involving the majority of the left frontal lobe, which exerts significant mass effect resulting in midline shift and effacement of the frontal horn of the lateral ventricle. The mass is heterogeneous, but predominantly hypointense on T1 with a surrounding mantle of tumor edema. Following contrast there is heterogeneous moderate enhancement.Source: Dr. Frank Gaillard. Radiopaedia
MRI including post contrast sequences demonstrates a large mass involving the majority of the left frontal lobe, which exerts significant mass effect resulting in midline shift and effacement of the frontal horn of the lateral ventricle. The mass is heterogeneous, but predominantly hyperintense on T2 with a surrounding mantle of tumor edema. Following contrast there is heterogeneous moderate enhancement.Source: Dr. Frank Gaillard. Radiopaedia

References

  1. ↑ Radiographic features of oligodendroglioma. Dr Henry Knipe and Dr Frank Gaillard et al. http://radiopaedia.org/articles/oligodendroglioma
  2. ↑ Stark AM, Hugo HH, Mehdorn HM, Knerlich-Lukoschus F (2009). "Acute Hydrocephalus due to Secondary Leptomeningeal Dissemination of an Anaplastic Oligodendroglioma". Case Rep Med. 2009: 370901. doi:10.1155/2009/370901. PMC 2797365. PMID 20052406.
  3. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
  4. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
  5. ↑ Image courtesy of Dr. Henry Knipe and Dr. Frank Gaillard et al. Radiopaedia (original file here). Creative Commons BY-SA-NC


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