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Oligodendroglioma MRI

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

Overview

Overview

Brain MRI is helpful in the diagnosis of oligodendroglioma. On brain MRI, oligodendroglioma is characterized by a mass which is typically hypointense on T1–weighted images and hyperintense on T2-weighted images. Calcification is observed as areas of “blooming” on T2 decay component of MRI. T1 C + gadolinium shows heterogeneous contrast enhancement and diffusion weighted images help differentiate lower grade oligodendrogliomas from higher grade astrocytomas which have higher ADC values because of lower cellularity and greater hyaluronan proportion. MR perfusion (PWI) is 95% sensitive for diagnosis of oligodendrogliomas and 87% sensitive for distinguishing grade II from grade III oligodendrogliomas. On PWI, “chicken wire” network of vascularityresults in elevated relative cerebral blood volume (rCBV) of grade II vs grade III and rCBV above the threshold of 1.75 demonstrates more rapid tumor progression.

MRI

MRI

MRI characteristics of oligodendroglioma
MRI component Findings

T1

  • Typically hypointense

T2

T2 decay

T1 C + gadolinium

Diffusion weighted images (DWI)

MR perfusion (PWI)

MRI axial FLAIR showing a relatively well circumscribed mass involving the temporal lobe and insular cortex, without convincing enhancement, and minimal restricted diffusion Source: Dr. Frank Gaillard. Radiopaedia
MR perfusion demonstrates significantly increased CBV (area ‘under’ the purple curve) compared to the other side.Source: Dr. Frank Gaillard. Radiopaedia
MR perfusion of the brain.Source: Dr. Frank Gaillard. Radiopaedia
A sharply defined zone of abnormal slightly heterogeneous signal in the left parietal lobe extends to involve the medial cortex of the superior parietal lobule. Inferiorly it abuts and distorts the cingulate gyrus. Superiorly it is significantly posterior to the precentral gyrus and slightly posterior to the left post central gyrus. Posterior and laterally it extends to and distorts the left intraparietal sulcus. It extends to within 1 cm of the parieto-occipital fissure postero-medially, slightly posteriorly bowing it. It exhibits no restricted diffusion and no pathological contrast enhancement.Source: Dr. Henry Knipe and Dr. Frank Gaillard et al. Radiopaedia
MRI including post contrast sequences demonstrates a large mass involving the majority of the left frontal lobe, which exerts significant mass effect resulting in midline shift and effacement of the frontal horn of the lateral ventricle. The mass is heterogeneous, but predominantly hyperintense on T2 with a surrounding mantle of tumor edema. Following contrast there is heterogeneous moderate enhancement.Source: Dr. Frank Gaillard. Radiopaedia
MRI including post contrast sequences demonstrates a large mass involving the majority of the left frontal lobe, which exerts significant mass effect resulting in midline shift and effacement of the frontal horn of the lateral ventricle. The mass is heterogeneous, but predominantly hypointense on T1 with a surrounding mantle of tumor edema. Following contrast there is heterogeneous moderate enhancement.Source: Dr. Frank Gaillard. Radiopaedia
A left frontal lobe mass with central haemorrhagic component is present (intrinsic high T1, low T2) with a peripheral region of enhancement and high T2 signal. Some of the enhancement may be in reaction to the haemorrhage, depending on the time course.Source: Dr. Henry Knipe and Dr. Frank Gaillard et al. Radiopaedia
References

References

  1. ↑ Radiographic features of oligodendroglioma. Dr Henry Knipe and Dr Frank Gaillard et al. http://radiopaedia.org/articles/oligodendroglioma
  2. ↑ Stark AM, Hugo HH, Mehdorn HM, Knerlich-Lukoschus F (2009). “Acute Hydrocephalus due to Secondary Leptomeningeal Dissemination of an Anaplastic Oligodendroglioma”. Case Rep Med. 2009: 370901. doi:10.1155/2009/370901. PMC 2797365. PMID 20052406.
  3. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
  4. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
  5. ↑ Image courtesy of Dr. Henry Knipe and Dr. Frank Gaillard et al. Radiopaedia (original file here). Creative Commons BY-SA-NC


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