EURORAD ESR

Case 15668

Diffuse Astrocytoma with protoplasmic pattern: MR imaging features of low grade infiltrative glial tumours.

Author(s)
Andrei D. Pantiru, Sara Márquez Batalla, Magaly Ibarra Hernández, Carolina Vargas Jiménez, José Manuel Villanueva Rincón, José Asensio Calle

Hospital Universitario de Salamanca, Sacyl, Radiology; 37007 Salamanca, Spain; Email:pantiru@hotmail.it
 
Patient
male, 56 year(s)
 
 
  • Figure 1
    Axial CT
     

    Axial NECT: hypodense lesion in the right cerebral hemisphere, with discrete mass effect on the adjacent falx cerebri and the ipsilateral cortical sulci.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Imaging sequences; Special Focus: Neoplasia;

    CECT: no significant enhancement. No evidence signs of acute hemorrhage or calcification.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 2
    Conventional MRI
     

    T1-W FSE: heterogeneous hypointense signal.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Axial T2-W: Hyperintense intraxial expansile mass lesion with broad cortical involvement. There is a prominent central cystic component with dark linear septations.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    The central cystic component completely supresses signal intensity on the FLAIR sequence.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Sagital T1 FSE: the lesion is located in the right parietal lobe.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Axial T1-W PostGd: No evidence of enhancement.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 3
    Diffusion Weighted Imaging
     

    DWI (b1000)

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Apparent Diffusion Coefficient (ADC): No signs of restricted diffusion of the solid component. Central cystic component with facilitaed diffusion.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 4
    Susceptibility Weighted Imaging

    Postprocessed SWI with mIP Reconstruction: No hypointense intralesional signal intensity to suggest calcification, hemosiderin or iron deposition.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 5
    Dynamic Susceptibility Contrast Enhanced MRI (DSC)

    CBV Map (DSC) Corregistration with T2: no elevated perfusion.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 6
    Spectroscopy MRI

    HMRS: Mildly elevated choline: creatin ratio, absence of lipids and lactate.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
Axial NECT: hypodense lesion in the right cerebral hemisphere, with discrete mass effect on the adjacent falx cerebri and the ipsilateral cortical sulci.
 
CECT: no significant enhancement. No evidence signs of acute hemorrhage or calcification.
 
T1-W FSE: heterogeneous hypointense signal.
 
Axial T2-W: Hyperintense intraxial expansile mass lesion with broad cortical involvement. There is a prominent central cystic component with dark linear septations.
 
The central cystic component completely supresses signal intensity on the FLAIR sequence.
 
Sagital T1 FSE: the lesion is located in the right parietal lobe.
 
Axial T1-W PostGd: No evidence of enhancement.
 
DWI (b1000)
 
Apparent Diffusion Coefficient (ADC): No signs of restricted diffusion of the solid component. Central cystic component with facilitaed diffusion.
 
Postprocessed SWI with mIP Reconstruction: No hypointense intralesional signal intensity to suggest calcification, hemosiderin or iron deposition.
 
CBV Map (DSC) Corregistration with T2: no elevated perfusion.
 
HMRS: Mildly elevated choline: creatin ratio, absence of lipids and lactate.
 
 
 
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