The MR imaging of the primary midbrain tumors
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Objective To describe the MRI features in 38 cases of midbrain tumors. Methods From 1993 to 1997,MRI was performed in 38 patients with midbrain tumors. There were 27 males and 11 females. Mean age was 24.9 years. All patients underwent surgical operation. Results Of the 38 patients, 11 tumors occurred predominantly in the tectum, 20 tumors in the tegmentum and 7 with downward extension to the pons, 7 tumors were located in the cerebral aqueduct. The histological diagnosis was lowgrade astrocytoma in 16 cases, highgrade astrocytoma in 15 cases, oligoastrocytoma in 5 cases, and ependymoma in 2 cases. Conclusions There was a wide variety of MRI features related to the site and pathology of midbrain tumors. With the advent of MRI, the delineation of the lesions is more precise, and the tumor type can usually be correctly assumed.Keywords:
Tectum
Tegmentum
Pons
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Objective To investigate MRI features of multiple cerebral gliomas(MCG).Methods MR images of 15 patients with MCG confirmed surgically and pathologically were analyzed retrospectively.Results Totally 50 lesions were detected in 15 patients with MCG.MRI finding were as follows: ①The amount and location of lesions in different cases were variable,and hippocampus(hippocampal gyrus) were the most commonly involved area(11/15,73.33%).②Histological grades of lesions in every case were also variable and presented differential features of MRI signal and degree of enhancement.③The progression of lesions in 3 followed-up cases was markedly different.④Fifteen lesions were pathologically confirmed,and anaplastic astrocytoma was proved to be the most common histological type(10/15,66.67%).Conclusion MRI findings of MCG have certain characteristic features that may reflect tissue differentiation of lesions and may play a valuable role in diagnosis of MCG.
Anaplastic astrocytoma
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Objective To investigate the MR imaging features and diagnostic points of anaplastic astrocytoma.Methods MR studies of 12 patients with pathologically confirmed anaplastic astrocytomas(WHO Ⅲ grade) were reviewed retrospectively.Results The tumors were mainly located in frontal lobe(50%),and 1 case presented multiple lesions.The tumors showed the performance of cystic-solid(83.33%).Compared with gray matter,solid part has a signal of iso-intensity in T1WI and slight hyper-intensity in T2WI and FLAIR,with an obviously irregular ring enhancement.The tumors were mainly located in the cortex and involved the white matter.Those tumors with large lesions exhibited necrosis or calcification inside them,heavily mass effect,peripheral edema,bad-demarcated border,and obviously oppressed surrounding tissue,offset the midline;while those tumors were rarely not overpassed to the contralateral hemisphere.The case of multiple lesions showed unspecific performance.Conclusion MRI can clearly detect the extent and feature of anaplastic astrocytoma and should be the first modality of choice in showing the tumor spectrum,which has a significant clinical value for the diagnosis of anaplastic astrocytoma and for the differential diagnosis.
Anaplastic astrocytoma
Fluid-attenuated inversion recovery
Anaplasia
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Objective To analyze and evaluate MR image features of cerebellar vermis tumors. Methods MRI features for 49 cases of cerebellar vermis tumors with operative and pathologic identification were studied retrospectively. All cases underwent plain and enhanced transverse, coronal, and sagittal MR scans. Results There were 20 cases of medulloblastomas, 12 cases of astryocytomas, 9 cases of hemangioblastomas, 4 cases of metastases, 2 cases of ependymomas, 1 case of chorial plexus and 1 case of cavernous hemangioma among the 49 cerebellar vermis tumors, most of them had characteristics MRI appearances and could be diagnosed before operation. Conclusion MRI is a method of choice in detecting cerebellar vermis tumors, an is significantly valuable in diagnosis and differential diagnosis of cerebellar vermis tumors.
Cerebellar vermis
Fourth ventricle
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ObjectiveThe aim was to study the role of MRI in diagnosis of pediatric posterior fossa tumors.BackgroundBrain tumors represent the most common solid neoplasms in children and the second most common pediatric malignancy following leukemia.Patients and methodsA retrospective study was conducted on 25 pediatric patients with known brain posterior fossa masses, who ranged in age from 1 to 15 years and had suspected posterior fossa tumor by computed tomography. All participants attended the MR unit of Radiology Department, Menoufia University, Menoufia Governorate, during the period from October 2016 to November 2017. Complete history taking, clinical examination, and MR data were compared with histopathology obtained from all patients.ResultsThe mean age of the cases was 7.2 ± 3.9 years. The most common tumors were medulloblastoma (MB) and pilocytic astrocytoma. MB showed restricted diffusion with low apparent diffusion coefficient value, and pilocytic astrocytoma showed free diffusion with higher apparent diffusion coefficient value. High-grade tumors such as MB and brain stem glioma showed elevated choline and reduced N-acetyl aspartate in magnetic resonance spectroscopy curve. Low-grade tumors such as low-grade glioma showed mild rise of choline and mild reduction of creatine in magnetic resonance spectroscopy curve.ConclusionConventional MRI provided limited information regarding tumor type and grade, falling short as a definitive diagnostic examination. Advanced brain MRI techniques provided incremental diagnostic value over conventional MRI. However, no single advanced technique was perfect, but different techniques typically complement one another.
Pilocytic astrocytoma
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Purpose: To explore the MRI manifestations of cerebral primitive neuroectodermal tumors(PNETs).Materials and Methods: The MRI findings of 5 cases cerebral PNETs proved by histology were analysed retrospectively.All cases were scanned with conventional plain and postcontrast MR sequences and 2 cases plus additional DWI.Results: The tumor located in frontal lobe(4 cases) and temporal(1 case).The tumor mainly involved cortex(4 cases) and deep white matter(1 case).Tumors showed long T1,long or slight long T2 signal intensity in 4 cases and mixed signal intensity in 1 case.DWI showed high signal intensity in the two cases.Four lesions accompanied with cystic change and 2 lesions with bleeding.All the tumors had some extent perifocal edema from obvious(3 cases),medium(1 case) to slight(2 cases),and had chaplet like(3 cases),floccular(1 case) or punctuate(1 case) contrast enhanced.The adjacent bone and meninges were eroded in 2 cases.Conclusion: Cerebral PNETs have some features on MRI,which may help the diagnosis.
Meninges
Frontal lobe
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Aim:To investigate the MRI features of supratentorial primitive neuroectodermal tumors(PENTs) in children.Methods:MRI findings of 8 cases with PNETs proved by operation and pathology were analyzed retrospectively.In all the 8 cases,conventional plain MR scans of brain were performed.Postcontrast MRI of brain were obtained in 6 cases.Postcontrast MRI of brain and the whole spine were done in 1 case.Results:The location of the supratentorial lesions in all the cases included parietal lobe in 3 cases,parietal-temporal lobe in 1 case,parietal-occipital lobe in 1 case,third ventricle in 1 case,anterior cranial fossa in 1 case and middle cranial fossa in 1 case.The lesions were round-like or lobulated in shape and well demarked.The lesions were slightly hypointense or isointense in all the 8 cases on T1WI,slightly hyperintense in 4 cases,hyperintense in 3 cases and isointense in one case on T2WI.Cystic degeneration could be seen in 5 cases,hemorrhage in 4 cases,and flow void vessels in 3 cases.There were no peritumoral edema in 6 cases,slight edema in 1 case and medium edema in 1 case.The lesions demonstrated obvious enhancement in 6 cases and slight enhancement in 1 case of which the lesion in the middle cranial fossa showed dissemination of cistern,ependyma of lateral ventricle and subarachnoid cavity of spinal column.Conclusion:MR findings of PNETs in children are rather characteristic.PNETs can be diagnosed and differentiated from other tumors by the location,boundary,signal intensity,the degree of edema,and enhancement of the lesions.
Anterior cranial fossa
Posterior cranial fossa
Ependyma
Middle cranial fossa
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Objective To describe the MRI features of midbrain tumors in 60 cases. Methods MRI was performed in all 60 patients with midbrain tumors. All patients underwent surgical operation. Results Of the 60 patients,MR imaging showed 11 tumors occurred predominantly in the tectum,20 tumors occurred predominantly in the tegmentum and 7 dowmward extension to the pons, 7 tumors located in the cerebral aqueduct. 11 tumors arising in the thalamic region and infiltrate into the mesencephalon. 11pineal tumors secondarily infiltrate the tectum. The histological diagnosis was low grade astrocytoma in 11 cases, highgrade astrocytoma in 15 cases,oligo astrocytoma in 5 cases, fibrillary astrocytoma in 5 cases, ependymoma in 2 cases, glioblastoma in 11 cases, another 11 cases was pineal parenchymal tumors and germinal cell tumors.Conclusion There exist a wide variation of MRI features related to the site and pathology of midbrain tumors. With the advent of MRI, the delineation of the lesions is more precisely presented, and the tumor type can usually be correctly assumed.
Tectum
Tegmentum
Pons
Cerebral aqueduct
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Objective:To investigate the MRI features of intracranial ganglioglioma.Methods:MR imaging,clinical and pathological features of gangliogliomas in 8 cases were analyzed retrospectively.Results:All cases were solitary.7 lesions were supratentorial,in which 3 lesions located frontal lobe,parietal lobe 2 cases,occipital lobe 1 case,1 lesions situated in the subtentorial region(in the cerebellum).Gangliogliomas may be divided into solid tumors and cystic tumors on the basis of their MR characteristics,in which 6 lesions were showed with cystic-solid pattern,2 lesions with solid.Peritumoral edema were not obvious for most tumors.On enhanced MRI,tumors may be various pattern enhancing.Conclusion:Gangliogliomas may present with some characteristic MRI findings.Some cases of cerebral ganglioglioma can be suggested in combination with clinical manifestation.
Ganglioglioma
Occipital lobe
Frontal lobe
Parietal lobe
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Objective:To investigate the MRI features of lateral ventricular astrocytoma, and their relationship to the circumventricular organs. Methods:The MRI features were retrospectively analyzed in 14 cases of astrocytoma in lateral ventricle proved by operation and pathology. Nonenhanced and contrast enhanced MRI scanning were done in all cases, including 8 males and 6 females. The patient’s age ranged from 13~62 years old with average age of 26 years old. Result: One case (1/ 14) as pilocytic astrocytoma; 7 cases (7/14) were of WHO grade Ⅱastrocytoma, 4 cases (4/14) were of WHO grade Ⅲ astrocytoma, 2 cases (2/14) were of WHO grade Ⅳ astrocytoma. In 11 cases, MRI appearance agree with the operations: 2 cases arised from the septum pellucidum, 3 cases situated near the foramen of Monro, 2 cases had obscure boundary with the corpus callosum, and 4 cases had obscure boundary with the thalamus. Conclusion: Base on tumor’s location, patient’s age, and their MRI appearance, it is possible to improve the diagnostic accuracy of lateral ventricular astrocytoma.
Pilocytic astrocytoma
Foramen
Ventricular system
Lateral ventricles
Central neurocytoma
Cerebral Ventricle Neoplasms
Fourth ventricle
Septum pellucidum
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Objective To study the role of diffusion-tensor imaging (DTI) in realizing growing pattern and resection of intra-axial brain tumors.Methods 41 cases with brain turnors underwent conventional MR and DTI imaging examinations and their neuro-function were evaluated before and after operation.The cases were divided into control group (23 cases) and study group (18 cases) randomly.After selection of operative approach based on conventional MRI and DTI respectively,all patients were operated under the microscope.The operating result,the change of neuro-function and the alternation of DTI were compared.Results The tumors were totally removed in 17 cases and 16 cases,subtotally in 4 cases and 1 case,partially in 2 cases (1 died) and 1 case in the control group and the study group,respectively. Histological results confirmed glioblastoma 25 cases,metastic tumor 5 cases,ependymoblastoma 1 case, oligodendroglioma 3 cases,astrocytoma and anaplastic astrocytoma 7 cases.Before operation,DTI showed that white matter tracts were only shifted in 21 cases ofglioblastoma and I case of ependymoblastoma which located in eloquent area,temporal-occipital part,deep temporal lobe and partially interrupted by tumors in 2 cases of metastic tumors located in temporal-occipital part and 8 cases of astrocytoma or anaplastic astrocytoma located in cerebral hemisphere.Other tumors did not invade white matter tracts.Postoperatively, DTI showed white matter tracts were damaged in 5 cases in the control group and 2 cases in the study group and all of the 7 patients developed corresponding disability.Conclusion DTI can evidently exhibit the relation between white matter tracts and brain tumor in the patients so that DTI contributes to a great extent to surgical planning,intraoperative preserve of white matter tracts as well as the increased proportion of tumor resection.
Anaplastic astrocytoma
Pilocytic astrocytoma
Brain tumor
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