J Korean Neurosurg Soc.  2014 Sep;56(3):261-264. 10.3340/jkns.2014.56.3.261.

Value of Perfusion Weighted Magnetic Resonance Imaging in the Diagnosis of Supratentorial Anaplastic Astrocytoma

• Lee KM
• Kim EJ
• Jahng GH
• Park BJ

• KMID: 2339968
• DOI: http://doi.org/10.3340/jkns.2014.56.3.261

Abstract

We report perfusion weighted imaging (PWI) findings of nonenhanced anaplastic astrocytoma in a 30-year-old woman. Brain magnetic resonance imaging showed a nonenhanced brain tumor with mild peritumoral edema on the right medial frontal lobe and right genu of corpus callosum, suggesting a low-grade glioma. However, PWI showed increased relative cerebral blood volume, relative cerebral blood flow, and permeability of nonenhanced brain tumor compared with contralateral normal brain parenchyma, suggesting a high-grade glioma. After surgery, final histopathological analysis revealed World Health Organization grade III anaplastic astrocytoma. This case demonstrates the importance of PWI for preoperative evaluation of nonenhanced brain tumors.

Keyword

Anaplastic astrocytoma; MRI; Perfusion weighted MRI

MeSH Terms

Adult
Astrocytoma*
Blood Volume
Brain
Brain Neoplasms
Corpus Callosum
Diagnosis*
Edema
Female
Frontal Lobe
Glioma
Humans
Magnetic Resonance Angiography
Magnetic Resonance Imaging*
Perfusion*
Permeability
World Health Organization

Figure

• 

  Fig. 1 T2-weighted image (A) shows homogenously hyperintense mass with mild peritumoral edema and contrast-enhanced T1-weighted image (B) shows homogenously hypointense mass without enhancement on the right medial frontal lobe and right genu of corpus callosum.

• 

  Fig. 2 Perfusion color maps derived from dynamic susceptibility contrast-enhanced perfusion weighted imaging show that the visual increase in the relative cerebral blood volume of 3.6 (A) and relative cerebral blood flow of 2.0 (B).

• 

  Fig. 3 Perfusion color maps derived from dynamic contrast-enhanced perfusion weighted imaging show that the visual increase in the area under curve (A) and permeability (ktrans) (B).

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