Diffuse midline gliomas, H3 K27M-mutant are associated with less peritumoral edema and contrast enhancement in comparison to glioblastomas, H3 K27M-wildtype of midline structures

Purpose The entity ‘diffuse midline glioma, H3 K27M-mutant (DMG)’ was introduced in the revised 4th edition of the 2016 WHO classification of brain tumors. However, there are only a few reports on magnetic resonance imaging (MRI) of these tumors. Thus, we conducted a retrospective survey focused on MRI features of DMG compared to midline glioblastomas H3 K27M-wildtype (mGBM-H3wt). Methods We identified 24 DMG cases and 19 mGBM-H3wt patients as controls. After being retrospectively evaluated for microscopic evidence of microvascular proliferations (MVP) and tumor necrosis by two experienced neuropathologists to identify the defining histological criteria of mGBM-H3wt, the samples were further analyzed by two experienced readers regarding imaging features such as shape, peritumoral edema and contrast enhancement. Results The DMG were found in the thalamus in 37.5% of cases (controls 63%), in the brainstem in 50% (vs. 32%) and spinal cord in 12.5% (vs. 5%). In MRI and considering MVP, DMG were found to be by far less likely to develop peritumoral edema (OR: 0.13; 95%-CL: 0.02–0.62) (p = 0.010). They, similarly, were associated with a significantly lower probability of developing strong contrast enhancement compared to mGBM-H3wt (OR: 0.10; 95%-CL: 0.02–0.47) (P = 0.003). Conclusion Despite having highly variable imaging features, DMG exhibited markedly less edema and lower contrast enhancement in MRI compared to mGBM-H3wt. Of these features, the enhancement level was associated with evidence of MVP.

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Intracranial Gliomas: Association between MRI Features and Tumor Grade

Bangladesh Journal of Neurosurgery ◽

10.3329/bjns.v8i2.42351 ◽

2019 ◽

Vol 8 (2) ◽

pp. 93-99

Author(s):

Md Rokibul Islam ◽

KM Tarikul Islam ◽

Moshiur Rahman ◽

Mohammad Hossain ◽

Raziul Haque ◽

...

Keyword(s):

Mr Imaging ◽

Contrast Enhancement ◽

Predictive Value ◽

Tumor Grade ◽

Mass Effect ◽

Low Grade ◽

Imaging Features ◽

Peritumoral Edema ◽

Cross Sectional ◽

Mri Features

Purpose: Intracranial gliomas are not uncommon in our country. The therapeutic management and prognosis in patients with gliomas depend on the reliable distinction between high and low-grade gliomas. The purpose of the present study was to determine whether any association exists between various individual MR imaging features and histopathologically determined tumor grade of intracranial gliomas. Our target was to explore whether MRI could enable correct determination the grading of gliomas which will help early diagnosis, staging, grade assessing, determining the appropriate treatment, preoperative planning for surgical resection and post operative management plan. Materials and Methods: It was a cross sectional type of observational study. This study was conducted on 44 cases of intracranial gliomas. Only patients having histopathologically proven intracranial gliomas who underwent surgery or stereotactic biopsy were considered as a study population. Results: The present study revealed that there is significant association between the MR imaging features and histopathological grading of intracranial gliomas. Contrast enhancement in MRI showed most significant (p<0.001). Other significant MR imaging features were peritumoral edema (p=0.001), tumor border definition (p=0.001), necrosis or cystic change of tumor (p=0.001) and mass effect (p=0.003). In this study preoperative MRI diagnosis was correct in 39 patients with accuracy of 88.6%. Sensitivity, specificity, positive predictive value and negative predictive value of MRI in detecting tumor grade were 86.4%, 90.9%, 90.5% and 87% respectively. Conclusion: MRI is sensitive, specific and accurate in assessing the grade of gliomas. Contrast enhancement is the most important predictor. Peritumoral edema, tumor border definition, mass effect and necrosis/cystic changes of tumor are also important indicators of tumor grade. Bang. J Neurosurgery 2019; 8(2): 93-99

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Myxofibrosarcoma: clinical and prognostic value of MRI features

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616999200729152135 ◽

2020 ◽

Vol 16 ◽

Cited By ~ 1

Author(s):

Paolo Spinnato ◽

Andrea Sambri ◽

Tomohiro Fujiwara ◽

Luca Ceccarelli ◽

Roberta Clinca ◽

...

Keyword(s):

Soft Tissue ◽

Local Recurrence ◽

Contrast Enhancement ◽

Imaging Modality ◽

Soft Tissue Sarcomas ◽

The Elderly ◽

High Rate ◽

Imaging Features ◽

High Grade ◽

Mri Features

: Myxofibrosarcoma is one of the most common soft tissue sarcomas in the elderly. It is characterized by an extremely high rate of local recurrence, higher than other soft tissue tumors, and a relatively low risk of distant metastases.Magnetic resonance imaging (MRI) is the imaging modality of choice for the assessment of myxofibrosarcoma and plays a key role in the preoperative setting of these patients.MRI features associated with high risk of local recurrence are: high myxoid matrix content (water-like appearance of the lesions), high grade of contrast enhancement, presence of an infiltrative pattern (“tail sign”). On the other hand, MRI features associated with worse sarcoma specific survival are: large size of the lesion, deep location, high grade of contrast enhancement. Recognizing the above-mentioned imaging features of myxofibrosarcoma may be helpful to stratify the risk for local recurrence and disease-specific survival. Moreover, the surgical planning should be adjusted according to the MRI features

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MRI features of different types of sinonasan rhabdomyosarcomas: a series of eleven cases

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20210030 ◽

2021 ◽

pp. 20210030

Author(s):

Junjie Zeng ◽

Lan Liu ◽

Jiayong Li ◽

Qiling Huang ◽

Leiming Pi ◽

...

Keyword(s):

Bone Destruction ◽

Imaging Features ◽

Resonance Imaging ◽

Bone Invasion ◽

Mri Features ◽

Different Types ◽

Magnetic Resonance Imaging Mri ◽

Haematogenous Metastasis ◽

Ethmoid Sinuses ◽

Pathological Subtypes

Objective: To retrospectively analyze magnetic resonance imaging (MRI) features of various pathological subtypes of sinonasal rhabdomyosarcoma (RMS) and explore correlations between imaging features and pathological subtypes. Methods: In total, 11 cases with embryonal, alveolar or pleomorphic sinonasal RMSs, confirmed by surgical pathology, were selected. Their characteristics and distinctive imaging features were analysed, and the correlation between pathology and imaging features was explored. Results: Bone destruction was observed in all 11 cases with RMS. Expansive growth was predominant in three alveolar and three embryonal RMS cases, and creeping growth was predominant in two alveolar, two embryonal and one pleomorphic RMS cases. Signs of residual mucosa were observed in all 11 cases, and 10 cases showed involvement of multiple sinus cavities and orbital cavities. All cases exhibited mild-to-intermediate enhancement. Conclusion: Sinonasal RMSs have the following characteristic MRI features: ethmoid sinuses and middle nasal conchae are the prevalent sites; lesions are mainly of mild enhancement; tumours exhibit signs of residual mucosa, mild-to-intermediate enhancement and frequent orbital involvement; bone invasion and bone destruction are frequently observed; and haematogenous metastasis is not as common as lymphatic metastasis. RMSs of various pathological subtypes were not significantly distinct by imaging.

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Unusual MR Imaging Features in CT Hyperdense Posterior Fossa Dermoids: Report of Two Cases

Indian Journal of Neurosurgery ◽

10.1055/s-0039-3402594 ◽

2020 ◽

Vol 09 (01) ◽

pp. 63-66

Author(s):

Anbazhagan Sathiaprabhu ◽

Nichanametla Sravani ◽

Krishnan Nagarajan ◽

Sekar Sabarish ◽

Kapil Patil

Keyword(s):

Magnetic Resonance ◽

Posterior Fossa ◽

Magnetization Transfer ◽

The Body ◽

Resonance Spectroscopy ◽

Imaging Features ◽

Signal Loss ◽

Mri Features ◽

Magnetic Resonance Imaging Mri ◽

T2 Hyperintensity

AbstractDermoids, either intracranial or in the rest of the body, usually have typical imaging findings due to their fat contents as fat density in computed tomography (CT) and T1- and T2-hyperintensity in magnetic resonance imaging (MRI). Variable imaging appearances have been described due to soft tissue contents, hair, calcification, or even tooth. Posterior fossa dermoids have been reported as a specific variant that shows hyperdensity in CT and mixed signal intensity in MRI. We report two cases of posterior fossa CT hyperdense dermoids that showed unusual MRI features in the form of signal loss in magnetization transfer images and lipid peak in magnetic resonance spectroscopy. Both patients underwent surgical resection and histopathological confirmation and the causes of this unusual imaging appearance are discussed.

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Imaging features of discospondylitis in cats

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x19869705 ◽

2019 ◽

Vol 22 (7) ◽

pp. 631-640 ◽

Cited By ~ 1

Author(s):

Sergio A Gomes ◽

Sebastien Behr ◽

Laurent S Garosi ◽

Ines Carrera ◽

Mike Targett ◽

...

Keyword(s):

Contrast Enhancement ◽

Imaging Features ◽

Nerve Roots ◽

Intervertebral Disc Space ◽

Disc Space ◽

Radiographic Findings ◽

Mri Features ◽

Vertebral Bodies ◽

Vertebral Endplates ◽

Short Tau Inversion Recovery

Objectives This study describes the imaging features of feline discospondylitis on MRI, comparing them with CT and radiographic findings where available. Methods The medical records of cats diagnosed with discospondylitis, presented to three referring institutions, were reviewed. MRI, CT and radiographic features were assessed by two of the authors independently. Results Fourteen sites of discospondylitis were retrospectively identified in 13 cats. The L7–S1 intervertebral disc space (IVDS) was affected in 7/14 (50%) cases. Characteristic MRI features included a hyperintense nucleus pulposus signal on T2-weighted (T2W) imaging (n = 10/14 [71%]) and short tau inversion recovery (STIR) imaging (n = 11/13 [85%]), with contrast enhancement in all (n = 11/11); involvement of adjacent vertebral endplates (n = 11/14 [79%]) and hyperintense neighbouring soft tissue on T2W (n = 11/14 [79%]) and STIR (n = 10/13 [77%]), with contrast enhancement in all (n = 11/11); and the presence of spondylosis deformans (n = 10/14 [71%]). Other features included narrowed or collapsed IVDS (n = 8/14 [57%]), contrast enhancement of vertebral bodies (n = 5/11 [46%]), epidural space involvement (n = 5/14 [36%]), compression of the spinal cord or nerve roots (n = 5/14 [36%]), paraspinal abscessation (n = 3/14 [21%]) and meningeal signal intensity abnormalities with contrast enhancement (n = 5/6 [83%]). These latter findings may indicate secondary focal meningitis. Radiographs were available covering five sites (in four cats) and CT covering three sites (in two cats). The most common radiological features were collapse or narrowing of the affected IVDS (80%) and endplate erosion (60%). No changes suggestive of discospondylitis were identifiable on radiography or CT in two sites (one cat), despite being identifiable on MRI. Repeated radiography in one case did not reveal complete radiological resolution following 9 months of treatment. Conclusions and relevance The results of this study indicate consistent MRI features of feline discospondylitis that should be considered in the diagnosis of this condition.

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Brainstem glioma: Prediction of histopathologic grade based on conventional MR imaging

The Neuroradiology Journal ◽

10.1177/1971400917743099 ◽

2017 ◽

Vol 31 (1) ◽

pp. 10-17 ◽

Cited By ~ 4

Author(s):

Yashar Moharamzad ◽

Morteza Sanei Taheri ◽

Farhad Niaghi ◽

Elham Shobeiri

Keyword(s):

Logistic Regression ◽

Mr Imaging ◽

Contrast Enhancement ◽

Binary Logistic Regression ◽

Binary Logistic Regression Analysis ◽

Low Grade ◽

Imaging Features ◽

High Grade ◽

Post Contrast ◽

Mri Features

Objective The objective of this article is to investigate the association between specific MR imaging findings and histopathologic grading (low-grade vs. high-grade) of brainstem gliomas (BSGs). Methods Sixty-two males and 34 females (mean (standard deviation, SD) age of 24.61 (17.20) years, range = 3 to 70 years) with histologically diagnosed BSG underwent conventional 1.5 T MR imaging, which included T1-weighted (T1W), T2W, and post-contrast T1W sequences. There were 39 children (mean age of 9.38 years) and 57 adults (mean age of 35 years). A binary logistic regression analysis was used to explore associations between MRI features and histopathological grade of the BSG. Results Binary logistic regression revealed that necrosis (adjusted odds ratio (OR) = 16.07; 95% confidence interval (CI) = 3.20 to 80.52; p = 0.001) and inhomogeneous contrast enhancement (adjusted OR = 8.04; 95% CI = 1.73 to 37.41; p = 0.008) as significant predictors of high-grade BSG. The equation (Nagelkerke R2 = 0.575) is Logit ( p high-grade BSG) = (2.77 × necrosis) + (2.08 × heterogeneous contrast enhancement) – 3.13. Sensitivity and specificity values were respectively 66.7% and 96.0% for necrosis and 85.7% and 65.9% for inhomogeneous contrast-enhancing lesions. In the pediatric age group, only inhomogeneous contrast enhancement (adjusted OR = 40; 95% CI = 3.95 to 445.73; p = 0.002) was a significant predictor for high-grade BSG. Conclusion Conventional MR imaging features such as necrosis and inhomogeneous contrast enhancement in adults and heterogeneous contrast enhancement in children suggest high-grade BSG.

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Imaging features of skeletal muscle lymphoma: a case report and literature review

BMC Medical Imaging ◽

10.1186/s12880-021-00667-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shuxi Gao ◽

Hong Shu ◽

Hua Yang

Keyword(s):

Skeletal Muscle ◽

Lower Extremity ◽

B Cell Lymphoma ◽

Imaging Features ◽

Left Lower Extremity ◽

Non Hodgkin Lymphoma ◽

Guided Biopsy ◽

Mri Features ◽

Positron Emission ◽

Magnetic Resonance Imaging Mri

Abstract Background Diffuse large B cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL), occurring predominantly in older people. Skeletal muscle lymphoma is a rare form of DLBCL, most frequently affecting the thigh, upper extremities, calf, and pelvis. Case presentation We report a case of skeletal muscle DLBCL that was diagnosed using ultrasound (US)-guided biopsy. A 70-year-old man presented with progressive swelling and pain in the left lower extremity and an elevated erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP), ferritin, and CA125 levels. US, magnetic resonance imaging (MRI), and computed tomography (CT) showed diffuse lesions in several muscles of the left lower extremity. Positron emission tomography/CT (PET/CT) showed FDG-uptake in the affected muscles. The patient was treated with chemotherapy and achieved a good response. A systematic review of the literature published between 1992 and 2019 was conducted to investigate the role of imaging, including imaging-guided biopsy, in the diagnosis of skeletal muscle lymphoma. Conclusions Skeletal muscle lymphoma is rare. US and MRI features include enlargement of muscular structures, with preservation of the architecture of the tissue and surrounding anatomical structures. Definitive diagnosis relies on histological and immunohistological analysis of a sample obtained through imaging-guided biopsy.

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1.5 Tesla Magnetic Resonance Imaging Features of Canine Intracranial Intra-axial Hematomas

Frontiers in Veterinary Science ◽

10.3389/fvets.2021.778320 ◽

2021 ◽

Vol 8 ◽

Author(s):

James Whitlock ◽

Andrew Holdsworth ◽

Carles Morales ◽

Laurent Garosi ◽

Inés Carrera

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Contrast Enhancement ◽

Clinical Signs ◽

Border Region ◽

Imaging Features ◽

Resonance Imaging ◽

Mri Findings ◽

Mri Features ◽

Mri Study

The differentiation of solitary intra-axial hematomas from hemorrhagic neoplasms based on their magnetic resonance imaging (MRI) features is challenging. The treatment and prognosis for these two disease entities are vastly different and distinction between them is often based on MRI findings alone. The aim of this study was to describe the 1.5 tesla MRI features of canine intra-axial hematomas and correlate these findings with the evolution of hemorrhages described in human brains. Retrospective evaluation of patient details, clinical signs, and MRI findings of dogs with intra-axial hematomas that were histopathologically confirmed or determined via repeat MRI study and/or resolution of neurological signs. Ten dogs met the inclusion criteria. All 10 hematoma lesions were determined to be 2–7 days in age. On MRI, all 10 hemorrhagic lesions were comprised of two distinct regions; a relatively thin T1-weighted (T1W), T2-weighted (T2W) and gradient echo (GRE) hypointense (9/10) peripheral border region and a large central region that was heterogenous but predominantly T1W, T2W and GRE hyperintense (8/10). The peripheral border region was complete in its integrity in all 10 cases on T2W and GRE sequences. Contrast enhancement was present in (6/10) hematoma lesions and was always peripheral in nature with no evidence of central enhancement associated with any of the lesions. An intra-axial hematoma should be suspected in solitary hemorrhagic space occupying lesions that have a complete hypointense peripheral rim, elicit a peripheral contrast enhancement pattern, and display the expected temporal pattern of hematoma evolution.

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Imaging features and classification of peritumoral edema in vestibular schwannoma

The Neuroradiology Journal ◽

10.1177/1971400919896253 ◽

2019 ◽

Vol 33 (2) ◽

pp. 169-173

Author(s):

Mario Giordano ◽

Venelin Gerganov ◽

Hussam Metwali ◽

Massimo Gallieni ◽

Madjid Samii ◽

...

Keyword(s):

Tumor Growth ◽

Tumor Volume ◽

Major Axis ◽

Imaging Features ◽

Peritumoral Edema ◽

Brainstem Tumor ◽

Fluid Attenuated Inversion Recovery ◽

The Difference ◽

Skull Base Meningiomas

Background Peritumoral edema (PTE) is rarely present in patients with vestibular schwannomas (VS). We studied the correlation between radiological tumor characteristics and the presence of edema, describe its magnetic resonance imaging features and classify the different edema patterns. Methods We analysed 605 consecutive patients treated for VS at our Institute. PTE was found in 30 patients, studied on fluid attenuated inversion recovery sequences and categorised as involving the brachium pontis, cerebellum and/or brainstem. Tumor volume, shape, surface, internal structure and axis of growth were evaluated and compared to a matched series of 30 patients without PTE. Results In our population of patients, 5% showed PTE. Edema involved the brachium pontis in 22 cases (88%), cerebellum in 15 (60%) and brainstem in 3 (12%). PTE was classified as mild (one region involved), moderate (two regions) and severe (three regions). Edema was present not only perpendicular to the major tumor growth axis but also parallel to it (91%). The difference between the two groups in regards to tumor shape and surface was not significant. We found no correlation between tumor and edema volumes. Conclusions VS can cause PTE, but its incidence is less frequent than in skull base meningiomas. PTE involves most frequently the brachium pontis, followed by the cerebellum and brainstem. Its occurrence correlates with tumor size but not with other radiological VS features. PTE is not always located perpendicular to the major axis of tumor growth, which indicated that the compressive theory proposed for meningiomas is not plausible explanation for its manifestation.

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Extrahepatic Alveolar Echinococcus on Multi-slice Computed Tomography and Magnetic Resonance Imaging

10.21203/rs.3.rs-135974/v1 ◽

2021 ◽

Author(s):

Guo Hui ◽

Wenya Liu ◽

Jian Wang ◽

Yan Xing

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Magnetic Resonance ◽

Adrenal Gland ◽

Kappa Statistics ◽

Imaging Features ◽

Resonance Imaging ◽

Mri Features ◽

Magnetic Resonance Imaging Mri ◽

The Brain

Abstract Background. Alveolar echinococcus (AE) is a severe health problem in endemic areas. In recent years, the incidence of this disease in China has been increasing. The study was designed to illustrate the multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) features of extrahepatic AE.Methods. A cohort of 33 patients who suffered from extrahepatic AE was enrolled consecutively from January 2012 to December 2017. The MSCT and MRI features of extrahepatic AE were recorded and analyzed by experienced radiologists. The MSCT and MRI agreements for detecting imaging features of extrahepatic AE were calculated using kappa statistics.Results. All cases secondary to hepatic AE, except two primary extrahepatic AE, were found in this study. Locations of extrahepatic AE included 19 (57.6%) lung, 10 (30.3%) adrenal gland, 9 (27.3%) brain, 5 (15.2%) peritoneal cavity, 5 (15.2%) spleen, 4 (12.1%) diaphragm, 3 (9.1%) kidney, 3 (9.1%) retroperitoneal, and 2 (6.1%) vertebra; Involvement of 1 (3.0%) heart, 1 (3.0%) mediastinum, 1 (3.0%) muscle, and 1 (3.0%) pancreas was rare. AE of the lung usually appeared as irregular and scattered nodules with small vacuoles or cavities inside and peripheral distribution. Multiple cerebral nodules with calcification and surrounding edema were the most common features seen in brain AE. Adrenal gland AE presented as plaques containing different sizes of hypodense areas and different amounts of calcification. Injection of contrast medium showed no enhancement of lesions except in the brain. Very good agreements were seen between MSCT and MR for detecting number (κ=0.841, p=0.000), border (κ=0.911, p=0.000) and size (κ=0.864, p=0.000) of extrahepatic AE.Conclusions. MSCT and MRI are reliable imaging methods for the diagnosis of extrahepatic AE. When one AE patient is clinically confirmed, MSCT scan from the head to pelvis should be performed to exclude other organs AE.

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