Gliomatosis Cerebri: A Review of 22 Cases

Neurosurgery ◽  
2003 ◽  
Vol 53 (2) ◽  
pp. 261-271 ◽  
Author(s):  
G. Edward Vates ◽  
Susan Chang ◽  
Kathleen R. Lamborn ◽  
Michael Prados ◽  
Mitchel S. Berger

Abstract OBJECTIVE Gliomatosis cerebri is an enigmatic diffuse brain neoplasm whose prognosis is grim. We reviewed data for patients with gliomatosis who were treated at the University of California, San Francisco, during a 10-year period. Our focus was on presentation, radiological and pathological features, and outcomes. METHODS We reviewed hospital and clinic records and magnetic resonance imaging scans for 22 patients with gliomatosis. The diagnosis was based on magnetic resonance imaging findings and tissue confirmation for all patients. Seven patients also underwent magnetic resonance spectroscopy. Eleven patients were male (50%), and the median age at presentation was 49 years (range, 7–79 yr). RESULTS Kaplan-Meier analysis demonstrated median lengths of survival as follows: no treatment, 1 month (n = 4); radiotherapy alone, 28 months (95% confidence interval, 5–51 mo; n = 13); radiotherapy followed by chemotherapy, two patients, alive at 28 and 104 months; radiotherapy and chemotherapy simultaneously, three patients, one alive at 18 months and the others dead at 7 and 9 months. There was no significant difference between radiotherapy alone and radiotherapy combined with chemotherapy (P = 0.69). Karnofsky Performance Scale scores of ≥70 and grade were both significantly related to length of survival in univariate analyses (P < 0.05); these correlations were confirmed in the multivariate analysis, although the small numbers of patients and deaths precluded reliable interpretation. CONCLUSION Although the small number of patients in our study and its retrospective nature preclude definitive conclusions regarding the utility of treatment, our findings suggest that biopsies are useful not only for diagnosis but also for prediction of the length of survival.

2014 ◽  
Vol 3 (7) ◽  
pp. 204798161454440 ◽  
Author(s):  
Tahir Durmus ◽  
Carsten Kamphues ◽  
Hendrik Blaeker ◽  
Christian Grieser ◽  
Timm Denecke

Inflammatory myofibroblastic tumors (IMT) are a benign tumor entity, which rarely develop in the liver. Surgery is the most common treatment for these lesions as it is difficult to distinguish them from malignant liver tumors and local recurrent growth may occur. IMT is a diagnostic challenge for imaging. Only a limited number of reports of single cases or small number of patients described the imaging features on computed tomography. Reports on IMT appearance on magnetic resonance imaging are scarce. We present a case of IMT of the liver with infiltration of the abdominal wall treated with surgery and describe the imaging features with the use of the hepatobiliary contrast agent, gadoxetic acid (Gd-EOB).


2017 ◽  
Author(s):  
Joshua P Klein

Modern neuroimaging has revolutionized the practice of neurology by allowing visualization and monitoring of evolving pathophysiologic processes. High-resolution magnetic resonance imaging (MRI) can now resolve structural abnormalities on a near-cellular level. Advances in functional imaging can assess the in vivo metabolic, vascular, and functional states of neuronal and glial populations in real time. Given the high density of data obtained from neuroimaging studies, it is essential for the clinician to take an active role in understanding the nature and significance of imaging abnormalities. This chapter reviews computed tomography and MRI techniques (including angiography and advanced sequences), specialized protocols for investigating specific diagnoses, risks associated with imaging, disease-specific imaging findings with general strategies for interpretation, and incidental findings and artifacts. Figures include computed tomography, T1- and T2-weighted signal intensity, diffusion-weighted magnetic resonance imaging, magnetic resonance spectroscopy, imaging in epilepsy and dementia, extra-axial versus intra-axial lesions, typical lesions of multiple sclerosis, spinal imaging, spinal pathology, vascular pathology, intracranial hemorrhage, and common imaging artifacts. Tables list Hounsfield units, patterns of enhancement from imaging, advanced techniques in imaging, magnetic resonance imaging sequences, and the evolution of cerebral infarction and intraparenchymal hemorrhage on magnetic resonance imaging. This review contains 12 figures, 6 tables, and 213 references.


2021 ◽  
Vol 15 (9) ◽  
pp. 4009-4011
Author(s):  
Saulat Sarfraz ◽  
Mahwish Farzana

Background: In spite of recent advances in the use of diagnostic imaging modalities none of them has a hundred percent accuracy. So, misdiagnosis still occurs. Many trials are being done to evaluate the accuracy of these tools individually or in combination. The most useful investigation is MRI which broadly gives information of lesion as well its relationship with surrounding structures. While magnetic resonance spectroscopy further characterizes the lesion into benign or malignant. So this study is bit superior giving more details. By enlarge histopathology is gold standard for ultimate diagnosis. However these radiological investigations are extremely important for preoperative planning as well management of the lesion. In this study we compare the diagnostic accuracy of Magnetic Resonance Spectroscopy (MRS) with conventional MRI (Magnetic Resonance Imaging) sequences for diagnosis of brain tumors keeping histopathology as gold standard. Methods: The study was performed in 150 clinically suspected cases which were referred to Radiology Department from OPD, Indoor, Emergency and private sources from outside the hospital. Results: Majority 85(56.7%) were adult males and 65(43.3%) were adult females. The study was divided into two major age groups. There were 33cases (22%) with average age 20-35 years. The other age group 36-50 years had 40(26.7%) Majority of the cases 77(51.3%) were of average >50 years of age. The higher age groups showed a female dominance. Histopathology of 100(66.7%) cases confirmed positive and 50(33.3%) negative for MR Spectroscopy. On comparison of conventional MRI with contrast, and Histopathology it was observed that the sensitivity of MRI was 74.0% and the specificity 82.0%.The positive and negative predictive values gave a lower accuracy rate of 76.6%. Conclusion: The conclusion of our study is that MRS is a rigorous, non-invasive, safe and convenient imaging modality for the evaluation of brain tumors as compared to MRI. Keywords: Brain tumors, MRI, MRS, Histopathology


2021 ◽  
Author(s):  
Dong Gyun Kim ◽  
Jeong Woo Yoo ◽  
Kyo Chul Koo ◽  
Byung Ha Chung ◽  
Kwang Suk Lee

Abstract INTRODUCTION: To analyze grayscale values for hypoechoic lesions matched with target lesions evaluated using prebiopsy magnetic resonance imaging (MRI). METHODS We collected data on 420 target lesions in patients who underwent MRI/transrectal ultrasound fusion biopsies. Images of hypoechoic lesions that matched the target lesions on MRI were stored in a picture archiving and communication system, and their grayscale values were estimated using the red/green/blue scoring method through an embedded function. We analyzed imaging data using grayscale values. RESULTS Of the 420 lesions, 261 (62.1%) were prostate cancer lesions. Grayscale ranges (42.6–91.8) were significant predictors of clinically significant prostate cancer (csPC) in multivariable logistic regression analyses. Area under the curve for detecting csPC using grayscale values along with conventional variables was 0.839, which was significantly higher than that for detecting csPC using only conventional variables (0.828; p = 0.036). Subgroup analysis revealed a significant difference for PI-RADS 3 lesions between grayscale values for benign and cancerous lesions (p = 0.008). Grayscale values were the only significant predictive factor (p = 0.005) for csPC. CONCLUSIONS Distribution of grayscale values according to PI-RAD 3 scores was useful, and the grayscale range (42.6–91.8) was an important factor for csPC diagnosis.


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