The Novel Features of Multiple Cerebral Gliomas on Magnetic Resonance Imaging

Abstract

Magnetic resonance imaging (MRI) is the golden standard for visualizing brain tumors. Cytotoxic edema and tumor angiogenesis characterize high-grade gliomas. Diffusion-weighted imaging (DWI) and contrast-enhanced scanning aid in estimating the blood supply to the tumor and the cytotoxic edema. The aim of the study was to characterize the histological grading of multiple cerebral gliomas (MCG) and the primary area affected by MCG via studying radiographic appearances by MRI imaging, including DWI signal, predilection site, and contrastenhanced scanning. Nineteen patients with MCG received MRI and contrast-enhanced MRI scanning prior to surgery. Twenty-six lesions from 20 patients included: seven astrocytomas (grade I-II) (7/26 lesions, 27%), 14 anaplastic astrocytomas (grade III) (14/26 lesions, 54%), and five glioblastomas (grade IV) (5/26 lesions, 19%). The hippocampus (hippocampal gyrus) was identified as the area most affected by the MCG in 14 of the patients (14/20 patients, 70%). In conclusion, the intensity of the DWI signal, the degree of enhancement, and the differentiation degree in the different MCG-affected areas in the same patient were inconsistent, and the progression of each lesion was varied. DWI and contrast-enhanced MRI scanning can aid in distinguishing high versus low-grade glioma. Furthermore, the results of the DWI and contrast-enhanced scanning were related to the glioma grade: a stronger DWI signal and contrast-enhanced scanning were observed in grade III-IV gliomas as compared to grade I-II gliomas. The anaplastic astrocytoma was the most common histological type, and the hippocampus (hippocampal gyrus), as a special area affected by MCG, should be noted.