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{{Subependymal giant cell astrocytoma}}
{{Subependymal giant cell astrocytoma}}
{{CMG}}{{AE}}{{SR}}
{{CMG}}, {{AE}}{{IO}}, {{SR}}


==Overview==
==Overview==
On brain [[Magnetic resonance imaging|MRI]], some of the findings that are suggestive of subependymal giant cell astrocytoma include T1 isointense and hypointense signal enhancement, T2 isointense and hyperintense signal enhancement, and enlargement of ventricles.


==MRI==
==MRI==
*Brain MRI may be helpful in the diagnosis of subependymal giant cell astrocytoma.
Brain [[Magnetic resonance imaging|MRI]] may be helpful in the diagnosis of subependymal giant cell astrocytoma. Findings on [[Magnetic resonance imaging|MRI]] suggestive of/diagnostic of subependymal giant cell astrocytoma include:<ref name="pmid26942030">{{cite journal| author=Stein JR, Reidman DA| title=Imaging Manifestations of a Subependymal Giant Cell Astrocytoma in Tuberous Sclerosis. | journal=Case Rep Radiol | year= 2016 | volume= 2016 | issue= | pages= 3750450 | pmid=26942030 | doi=10.1155/2016/3750450 | pmc=4752974 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26942030  }} </ref><ref name="BeaumontGodzik2015">{{cite journal|last1=Beaumont|first1=Thomas L.|last2=Godzik|first2=Jakub|last3=Dahiya|first3=Sonika|last4=Smyth|first4=Matthew D.|title=Subependymal giant cell astrocytoma in the absence of tuberous sclerosis complex: case report|journal=Journal of Neurosurgery: Pediatrics|volume=16|issue=2|year=2015|pages=134–137|issn=1933-0707|doi=10.3171/2015.1.PEDS13146}}</ref>
*Findings on MRI suggestive of subependymal giant cell astrocytoma are tabulated below:<ref name=MRIPA1>Radiographic features MRI of pilocytic astrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/pilocytic-astrocytoma. Accessed on October 27, 2015</ref><ref name="KumarLeeds2010">{{cite journal|last1=Kumar|first1=Ashok J.|last2=Leeds|first2=Norman E.|last3=Kumar|first3=Vinodh A.|last4=Fuller|first4=Gregory N.|last5=Lang|first5=Frederick F.|last6=Milas|first6=Zvonimir|last7=Weinberg|first7=Jeffrey S.|last8=Ater|first8=Joann L.|last9=Sawaya|first9=Raymond|title=Magnetic Resonance Imaging Features of Pilocytic Astrocytoma of the Brain Mimicking High-Grade Gliomas|journal=Journal of Computer Assisted Tomography|volume=34|issue=4|year=2010|pages=601–611|issn=0363-8715|doi=10.1097/RCT.0b013e3181d77d52}}</ref><ref name="WalkoffDegnan2013">{{cite journal|last1=Walkoff|first1=Lara|last2=Degnan|first2=Andrew Joseph|last3=Ghassibi|first3=Mark|last4=Jones|first4=Robert V|last5=Sherman|first5=Jonathan H|last6=Levy|first6=Lucien M|title=Neuroimaging of a Pilocytic Astrocytoma with Anaplastic Features and Diffusion Tensor Imaging Characteristics|journal=Radiology Case Reports|volume=8|issue=2|year=2013|issn=1930-0433|doi=10.2484/rcr.v8i2.753}}</ref>
*Well circumscribed [[mass]]
*Perilesional [[edema]]
*T1 isointense and hypointense signal enhancement
*T2 isointense and hyperintense signal enhancement
*[[Calcification]]
*[[Cyst]]
*Enlargement of ventricles
*Homogenous postcontrast enhancement


{| style="border: 0px; font-size: 90%; margin: 3px; width:650px"
Serial [[Magnetic resonance imaging|MRI's]] every 1-3 years is recommended in [[asymptomatic]] patients younger than 25 as [[tumor]] growth is more common in these patients.<ref name="pmid26942030">{{cite journal| author=Stein JR, Reidman DA| title=Imaging Manifestations of a Subependymal Giant Cell Astrocytoma in Tuberous Sclerosis. | journal=Case Rep Radiol | year= 2016 | volume= 2016 | issue=  | pages= 3750450 | pmid=26942030 | doi=10.1155/2016/3750450 | pmc=4752974 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26942030  }} </ref>
|valign=top|
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|MRI component}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Findings}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center |
T1
| style="padding: 5px 5px; background: #F5F5F5;" |
*Heterogenous and hypo- to isointense to grey matter
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align=center|
T2
| style="padding: 5px 5px; background: #F5F5F5;" |
*Heterogenous and hyperintense to grey matter
*Calcified components can be hypointense
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align=center|
T1 with gadolinium contrast
| style="padding: 5px 5px; background: #F5F5F5;" |
*Marked enhancement
|}


==Gallery==
[[File:SEGA MRI.jpg|400px|thumb|left|Axial T2 MRI showing a large lobulated intensely enhancing mass arising from the left foramen of Monro causing mild hydrocephalus. [https://radiopaedia.org/articles/subependymal-giant-cell-astrocytoma?lang=us source:Case courtesy of Dr Amro Omar, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/36589">rID: 36589</a>]]]
<gallery>
<br style="clear:left" />
 
Image:Subependymal giant cell astrocytoma MRI 1.jpg|<sub>Two girls ([A] 9 and [B] 12 years old) with acute headaches and vomiting. On examination, both had papilledema. Brain magnetic resonance imaging shows ventricular subependymal giant cell astrocytomas with secondary hydrocephalus.<ref name="RothRoach2013">{{cite journal|last1=Roth|first1=Jonathan|last2=Roach|first2=E. Steve|last3=Bartels|first3=Ute|last4=Jóźwiak|first4=Sergiusz|last5=Koenig|first5=Mary Kay|last6=Weiner|first6=Howard L.|last7=Franz|first7=David N.|last8=Wang|first8=Henry Z.|title=Subependymal Giant Cell Astrocytoma: Diagnosis, Screening, and Treatment. Recommendations From the International Tuberous Sclerosis Complex Consensus Conference 2012|journal=Pediatric Neurology|volume=49|issue=6|year=2013|pages=439–444|issn=08878994|doi=10.1016/j.pediatrneurol.2013.08.017}}</ref></sub>
Image:Subependymal giant cell astrocytoma MRI 2.jpg|<sub>This 6-year-old girl had a growing but asymptomatic tumor. (A) Her screening magnetic resonance imaging at age 2 revealed a subependymal giant cell astrocytoma with mild enlargement of the right lateral ventricle. (B) By age 6 years, the lesion had enlarged markedly.<ref name="RothRoach2013">{{cite journal|last1=Roth|first1=Jonathan|last2=Roach|first2=E. Steve|last3=Bartels|first3=Ute|last4=Jóźwiak|first4=Sergiusz|last5=Koenig|first5=Mary Kay|last6=Weiner|first6=Howard L.|last7=Franz|first7=David N.|last8=Wang|first8=Henry Z.|title=Subependymal Giant Cell Astrocytoma: Diagnosis, Screening, and Treatment. Recommendations From the International Tuberous Sclerosis Complex Consensus Conference 2012|journal=Pediatric Neurology|volume=49|issue=6|year=2013|pages=439–444|issn=08878994|doi=10.1016/j.pediatrneurol.2013.08.017}}</ref></sub>
Image:Subependymal giant cell astrocytoma MRI 3.jpg|<sub>Subependymal giant cell astrocytoma of the type associated with tuberous sclerosis are typically bulky, contrast-enhancing mass in the region of the foramen of Monro. Most overlie the head of the caudate nucleus. Foramen obstruction has produced hydrocephalus.<ref name=Radiologyfeaturesofsega1>Radiology features of subependymal giant cell astrocytoma. Libre pathology 2015. http://librepathology.org/wiki/index.php/Subependymal_giant_cell_astrocytoma. Accessed on November 2, 2015</ref>
 
</gallery>
 
==Reference==


==References==
{{reflist|2}}
{{reflist|2}}


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Latest revision as of 21:04, 5 November 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2], Sujit Routray, M.D. [3]

Overview

On brain MRI, some of the findings that are suggestive of subependymal giant cell astrocytoma include T1 isointense and hypointense signal enhancement, T2 isointense and hyperintense signal enhancement, and enlargement of ventricles.

MRI

Brain MRI may be helpful in the diagnosis of subependymal giant cell astrocytoma. Findings on MRI suggestive of/diagnostic of subependymal giant cell astrocytoma include:[1][2]

  • Well circumscribed mass
  • Perilesional edema
  • T1 isointense and hypointense signal enhancement
  • T2 isointense and hyperintense signal enhancement
  • Calcification
  • Cyst
  • Enlargement of ventricles
  • Homogenous postcontrast enhancement

Serial MRI's every 1-3 years is recommended in asymptomatic patients younger than 25 as tumor growth is more common in these patients.[1]

Axial T2 MRI showing a large lobulated intensely enhancing mass arising from the left foramen of Monro causing mild hydrocephalus. source:Case courtesy of Dr Amro Omar, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/36589">rID: 36589</a>


References

  1. 1.0 1.1 Stein JR, Reidman DA (2016). "Imaging Manifestations of a Subependymal Giant Cell Astrocytoma in Tuberous Sclerosis". Case Rep Radiol. 2016: 3750450. doi:10.1155/2016/3750450. PMC 4752974. PMID 26942030.
  2. Beaumont, Thomas L.; Godzik, Jakub; Dahiya, Sonika; Smyth, Matthew D. (2015). "Subependymal giant cell astrocytoma in the absence of tuberous sclerosis complex: case report". Journal of Neurosurgery: Pediatrics. 16 (2): 134–137. doi:10.3171/2015.1.PEDS13146. ISSN 1933-0707.


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