Glioma MRI

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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