Brain Stem Gliomas MRI

Jump to navigation Jump to search

Brain Stem Gliomas Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Brain Stem Gliomas from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Brain Stem Gliomas MRI On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Brain Stem Gliomas MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Brain Stem Gliomas MRI

CDC on Brain Stem Gliomas MRI

Brain Stem Gliomas MRI in the news

Blogs on Brain Stem Gliomas MRI

Directions to Hospitals Treating Brain Stem Gliomas

Risk calculators and risk factors for Brain Stem Gliomas MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

On MRI brain, diffuse brainstem glioma is characterized by decreased intensity on T1, heterogenously increased on T2. Focal brainstem glioma is characterized by iso- to hypointense to grey matter on T1, and hyperintense to grey matter on T2.

MRI

MRI brain is the imaging modality of choice for brainstem gliomas. The findings will vary with the tumor type.[1]

Diffuse brainstem gliomas

The pons is enlarged, with the basilar artery displaced anteriorly against the clivus and potentially engulfed. The floor of the fourth ventricle is flattened ("flat floor of fourth ventricle sign") and obstructive hydrocephalus may be present. Occasionally the tumor is exophytic, either outwards into the basal cisterns or centrally in the fourth ventricle. Usually the tumor is homogenous pre-treatment, however in a minority of patients areas of necrosis may be present.

  • T1: Decreased intensity
  • T2: Heterogeneously increased
  • T1 C+ (Gd): Usually minimal (can enhance post radiotherapy)
  • Diffusion weighted imaging (DWI): Usually normal, occasionally mildly restricted

Focal brainstem glioma

  • Tectal glioma subtype

Typically the tumors demonstrate expansion of the tectal plate by a solid nodule of tissue.

  • T1: Iso- to slightly hypointense to grey matter
  • T2: Hyperintense to grey matter
  • T1 C+ (Gd): Usually no enhancement

With time the mass can develop small cystic spaces (sometimes associated with neurological deficits) or calcification. Higher grade tumors tend to be larger and tend to enhance more vividly.

References

  1. Imaging of Brainstem gliomas. Dr Yuranga Weerakkody and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/brainstem-glioma

Template:WH Template:WS