Brain Stem Gliomas MRI

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Brain Stem Gliomas Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

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Differentiating Brain Stem Gliomas from other Diseases

Epidemiology and Demographics

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Natural History, Complications and Prognosis

Diagnosis

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Case #1

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

Overview

MRI

MRI 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 4th 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)
    • DWI: usually normal, occasionally mildly restricted

References

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

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