Fig 2.1B: Axial T1 Weighted (Wtd.) MRIFig 2.1A: Axial Flair MRI Fig 2.1C: Post-Contrast Axial T1 Wtd. MRI

Fig 2.1D: Post Contrast Coronal T1 Wtd. MRI Fig 2.1E: Post Contrast Sagital T1 Wtd. MRI

56 Year-old male with 3 month history of gradual weakness of the right upper extremity.

Diagnosis: ???

Fig 2.2B: Axial T1 Wtd. MRIFig 2.2A: Axial Flair MRI Fig 2.2C: Post-Contrast Axial T1 Wtd. MRI

Fig 2.2D: Post Contrast Coronal T1 Wtd. MRI

51 Year-old male with history of seizures and was involved in a car accident, leading to imaging studies.

Diagnosis: ???

Fig 2.3B: Axial T1 Wtd. MRIFig 2.3A: Axial Flair MRI Fig 2.3C: Post-Contrast Axial T1 Wtd. MRI

Fig 2.3D: Post Contrast Sagital T1 Wtd. MRI

19 Year-old young lady with seizures and headache

Diagnosis: ???

Fig 2.4B: Axial T1 Wtd. MRIFig 2.4A: Axial T2 Wtd. MRI Fig 2.4C: Post-Contrast Axial T1 Wtd. MRI

Fig 2.4D: Post Contrast Coronal T1 Wtd. MRI

12 Year-old boy with headache, nausea and vomiting for three months.

Diagnosis: ???

Fig 2.5B: Axial T1 Wtd. MRIFig 2.5A: Axial Flair MRI Fig 2.5C: Post-Contrast Axial T1 Wtd. MRI

Fig 2.5D: Post Contrast Coronal T1 Wtd. MRI

60 Year-old male with six month history of gradual memory loss, disorientation and headache.

Diagnosis: ???

Fig. 2.1

Fig. 2.2

Fig. 2.3

Fig. 2.4

Fig. 2.5

Match the following Gliomas shown in figs 2.1 thru 2.5 to WHO (World Health Organization) Classification:

A. Butterfuly Glioblastoma

B. Grade 2 Astrocytoma

C. Pilocytic Astrocytoma (Grade 1 Astrocytoma)

D. Glioblastoma (Grade 4 Astrocytoma)

E. Anaplastic Astrocytoma Grade 3

See Next Panel for Correct Answers

Fig. 2.1

Fig. 2.2

Fig. 2.3

Fig. 2.4

Fig. 2.5

Match the following Gliomas shown in figs 2.1 thru 2.5 to WHO (World Health Organization) Classification:

A. Butterfuly Glioblastoma

B. Grade 2 Astrocytoma

C. Pilocytic Astrocytoma (Grade 1 Astrocytoma)

D. Glioblastoma (Grade 4 Astrocytoma)

E. Anaplastic Astrocytoma Grade 3

Correct Answers

Fig 2.1B: Axial T1 Weighted (Wtd.) MRI

Fig 2.1A: Axial Flair MRI Fig 2.1C: Post-Contrast Axial T1 Wtd. MRI

An irregular enhancing ring lesion (arrow) is seen involving the left parietal lobe. Tumor is associated with edema (E) best noticed on FLAIR image (A).

DIAGNOSIS: GLIOBLASTOMA

E

• Grade IV Astrocytoma (WHO Classification)

• Older Patient

•Imaging Features: Tumor with irregular peripheral enhancement with central necrosis.

•Median survival is 1 – 2 years following Surgery/Radiation therapy/Chemotherapy.

Fig 2.2B: Axial T1 Wtd. MRIFig 2.2A: Axial Flair MRI Fig 2.2C: Post-Contrast Axial T1 Wtd. MRI Fig 2.2D: Post Contrast Coronal T1 Wtd. MRI

An ill-defined non-enhancing tumor (yellow arrows) is seen in the left parietal lobe with spotty areas of enhancement (red arrows).

DIAGNOSIS: Anaplastic Astrocytoma

• Grade III Astrocytoma (WHO Classification)

• Usually seen between 40 – 60 years of age

• Imaging Features: Ill-defined non-enhancing tumor with or without feeble enhancement.

• Median survival is 5 – 6 years following Surgery/Radiation therapy/Chemotherapy.

Fig 2.3B: Axial T1 Wtd. MRIFig 2.3A: Axial Flair MRI Fig 2.3C: Post-Contrast Axial T1 Wtd. MRI

Non-enhancing tumor (arrow) involving the right temporal lobe.

DIAGNOSIS: GRADE III ASTROCYTOMA (LOW GRADE)

• Children and young adults

• Imaging Features: Non-enhancing tumors. Calcification can be seen.

• Total cure from surgery to median survival of 7- 10 years.

Fig 2.4B: Axial T1 Wtd. MRIFig 2.4A: Axial T2 Wtd. MRI Fig 2.4C: Post-Contrast Axial T1 Wtd. MRI

A large cystic tumor (yellow arrow) with a mural enhancing nodule (red arrow) is seen within the left cerebellar hemisphere.

DIAGNOSIS: PILOCYTIC ASTROCYTOMA

• Grade I Astrocytoma (WHO Classification)

• Children and young adults

• Imaging Features: cyst within enhancing tumor nodule.

• Surgical resection can result in complete cure.