scholarly journals Intracranial Gliomas: Association between MRI Features and Tumor Grade

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

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

2017 ◽  
Vol 31 (1) ◽  
pp. 10-17 ◽  
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.

Vaginal masses: magnetic resonance imaging features with pathologic correlation

2007 ◽  
Vol 48 (8) ◽  
pp. 921-933 ◽  
Author(s):  
K. M. Elsayes ◽  
V. R. Narra ◽  
J. R. Dillman ◽  
V. Velcheti ◽  
O. Hameed ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Pelvic Mri ◽  
Mri Features ◽  
Cross Sectional Imaging ◽  
Magnetic Resonance Imaging Mri

The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI)—with its high-contrast resolution and multiplanar capabilities—is often useful for characterizing vaginal masses. Vaginal masses can be classified as congenital, inflammatory, cystic (benign), and neoplastic (benign or malignant) in etiology. Recognition of the typical MR imaging features of such lesions is important because it often determines the treatment approach and may obviate surgery. Finally, vaginal MR imaging can be used to evaluate post-treatment changes related to previous surgery and radiation therapy. In this article, we will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation.

scholarly journals 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

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0249647
Author(s):  
Rouzbeh Banan ◽  
Arash Akbarian ◽  
Majid Samii ◽  
Amir Samii ◽  
Helmut Bertalanffy ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Lower Probability ◽  
Imaging Features ◽  
Peritumoral Edema ◽  
Mri Features ◽  
Histological Criteria ◽  
Magnetic Resonance Imaging Mri ◽  
Lower Contrast ◽  
Diffuse Midline Glioma

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.

Oligodendrogliomas: A comparison of CT and MR imaging features with histological malignancy grading in 20 cases: A pathoradiological study

2002 ◽  
Vol 43 (5) ◽  
pp. 474-482 ◽  
Author(s):  
W. Reiche ◽  
I. Grunwald ◽  
K. Hermann ◽  
M. Deinzer ◽  
W. Reith
Keyword(s):  
Mr Imaging ◽  
Contrast Enhancement ◽  
P Value ◽  
Low Grade ◽  
Imaging Features ◽  
Tumour Grade ◽  
Who Grade ◽  
Malignancy Grading ◽  
Grade Ii ◽  
Histological Malignancy

Purpose: To study the pattern of contrast enhancement in MR and CT of oligodendrogliomas and to compare this with other imaging findings and with histopathological grading criteria. Material and Methods: 20 patients with oligodendrogliomas (12 low-grade WHO II and 8 anaplastic WHO III) were reviewed. 20 complete MR investigations, 20 non-enhanced CT studies and 16 CTs after contrast enhancement were estimated blindly without knowledge of the tumour histological grades. Results: All anaplastic oligodendrogliomas showed tumour contrast enhancement on MR and CT images. Also in 6/12 low-grade oligodendrogliomas the contrast was enhanced on MR imaging. In 5 of these, tumour calcifications were detected by CT. The remaining 6/12 WHO grade II cases showed no significant MR contrast enhancement. Of the oligodendrogliomas grade II, CT showed contrast uptake in 3 cases and no enhancement in 6, while in 3 cases postcontrast CT was not available. A comparison of contrast enhancement with tumour grade resulted in a p-value of 0.042 for MR and of 0.011 for CT. A combined statistical test of tumour grade and calcifications detected by CT compared with MR contrast enhancement showed a significant correlation ( p=0.014). Conclusion: These data demonstrated that a clear grading of oligodendrogliomas based on the image criterion MR contrast enhancement was not possible. We suppose that, besides tumour neovascularisation, additional factors such as calcifications may disturb the blood-brain barrier.

Myxofibrosarcoma: clinical and prognostic value of MRI features

2020 ◽  
Vol 16 ◽  
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

scholarly journals Imaging features and surgery-related outcomes in intraventricular neurocysticercosis

2002 ◽  
Vol 12 (6) ◽  
pp. 1-8 ◽  
Author(s):  
Jonathan Stuart Citow ◽  
J. Patrick Johnson ◽  
Duncan Q. McBride ◽  
Mario Ammirati
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Computerized Tomography ◽  
Failure Rate ◽  
Treatment Algorithm ◽  
Parasitic Infection ◽  
Mass Effect ◽  
The United States ◽  
Imaging Features ◽  
Presenting Symptoms

Object Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system, and its prevalence is continuing to increase in the United States. The diagnosis of intraventricular NCC (IVNCC) may be difficult, and surgery frequently fails to resolve symptoms. A retrospective review of magnetic resonance (MR) imaging characteristics and surgery-related outcomes may improve management strategies of this disease. Methods The authors report the presentations, neuroimaging characteristics, surgical management, and outcomes of 30 patients with IVNCC treated over a 10-year period (mean follow-up period 4 years). Cysts were located in the lateral ventricles (five cases), the third ventricle (five cases), and the fourth ventricle (21 cases). One patient had lesions in both the lateral and fourth ventricles. Presenting symptoms were related to hydrocephalus or mass effect from the lesions. All patients underwent computerized tomography (CT) and MR imaging of the brain. Treatment consisted of shunt implantation or primary excision of an IVNCC lesion. Outcomes after operations and reoperations were evaluated in light of enhancement characteristics on MR imaging. Computerized tomography scanning demonstrated IVNCC lesions in 10% of cases, and MR revealed lesions in 100% of cases. In patients in whom gadolinium (Gd) enhancement of IVNCC lesions was demonstrated on MR imaging, the surgery-related failure rate was higher and patients required reoperation, and in those in whom gadolinium enhancement was absent the surgery-related failure rate was lower (64 and 19%, respectively; p < 0.0002). Conclusions Magnetic resonance imaging is superior to CT scanning for detecting IVNCC lesions. The absence of pericystic Gd enhancement on MR imaging is an indication for excision of the lesions. If pericystic enhancement is present, shunt surgery should be performed, and craniotomy reserved for treatment of those patients with symptomatic lesions secondary to mass effect. A treatment algorithm based on patient symptoms, cyst location, and MR imaging Gd enhancement characteristics is proposed.

scholarly journals Prognostic value of magnetic resonance imaging features in low-grade gliomas

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Liang Deng ◽  
Liangfang Shen ◽  
Lin Shen ◽  
Zhao Zhao ◽  
Yingpeng Peng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multivariate Analysis ◽  
Magnetic Resonance ◽  
Low Grade ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Mr Images ◽  
Low Grade Gliomas ◽  
Kaplan Meier ◽  
Mri Features

AbstractIntroduction: The treatment strategy for low-grade gliomas (LGGs) is still controversial, and there are no standardized criteria to predict the prognosis of patients with LGGs. Magnetic resonance imaging (MRI) is a routine test for preoperative diagnosis for LGG and can reflect the destructive features for the tumor. In the present study, we aimed to explore the relationship between the MRI features and prognosis in patients with LGG.Methods: Clinical data of 80 patients with pathologically proved LGGs between January 2010 and December 2016 were analyzed retrospectively. MRI features were classified as contrast enhancement pattern (focal enhancement, diffuse enhancement and ring-like enhancement), necrosis and cysts based on the preoperative MR images. Kaplan–Meier method and multivariate analysis were performed on the data by SPSS software to explore the prognostic significance of MRI features.Results: Patients with cystic LGG had a significantly longer 5-year progression-free survival (PFS) than that with no cyst (90.9 ± 8.7 vs 65.7 ± 9.1%, P=0.045). Multivariate analysis further verified cyst as an independent prognosis factor for PFS (P=0.027, hazard ratio [HR] = 0.084). Additionally, patients with ring-like enhancement exhibited significantly longer 5-year PFS time in the Kaplan–Meier survival curves (100 vs 67.2 ± 7.7%, P=0.049). There was no significant difference in PFS and overall survival (OS) between patients with or without necrosis.Conclusion: Our study suggests that cyst formation and ring-like enhancement on preoperative MR images can be useful to predict a favorable prognosis in patients with LGGs.

scholarly journals Imaging features of discospondylitis in cats

2019 ◽  
Vol 22 (7) ◽  
pp. 631-640 ◽  
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.

scholarly journals Distinct imaging patterns of pseudoprogression in glioma patients following proton versus photon radiation therapy

2021 ◽  
Author(s):  
Reed Ritterbusch ◽  
Lia M. Halasz ◽  
Jerome J. Graber
Keyword(s):  
Radiation Therapy ◽  
Mr Imaging ◽  
Tumor Progression ◽  
Clinical Symptoms ◽  
Molecular Subtype ◽  
Tumor Grade ◽  
Photon Radiation ◽  
Low Grade ◽  
Mean Time

Abstract Purpose Criteria by the Radiologic Assessment in Neuro-Oncology (RANO) group outline the diagnosis of pseudoprogression (Ps) after photon therapy for gliomas based on timing and location. We noted that patients receiving proton therapy manifested radiographic changes that appear different than Ps after photon therapy, which could be interpreted as tumor progression. In this study, we retrospectively reviewed MR imaging after proton or photon radiation for gliomas. We propose criteria to characterize proton pseudoprogression (ProPs) as distinct from Ps seen after photons. Methods Post-treatment MR imaging, clinical and pathological data of low grade glioma patients were reviewed. Overall, 57 patients receiving protons were reviewed for the presence of ProPs, and 43 patients receiving photons were reviewed for any equivalent imaging changes. Data collected included the location and timing of the new enhancement, tumor grade, molecular subtype, chemotherapy received, and clinical symptoms. Results Fourteen patients (24.6%) had new enhancement following radiation therapy that was unique to treatment with protons. The mean time to development of the ProPs was 15.4 months (7–27 months). We established the following criteria to characterize ProPs: located at the distal end of the proton beam; resolves without tumor-directed therapy; and subjectively multifocal, patchy, and small (< 1 cm). In the group receiving photons, none had changes that met our criteria for ProPs. Conclusion Patients who receive protons have unique imaging changes after radiation therapy. ProPs could be mistaken for tumor progression, but typically resolves on follow up. Further studies are needed to understand the radiobiology and pathophysiology underlying these imaging changes.

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

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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