Mri findings of supratentorial gliomas : a radiopathological comparative study

Abstract EN

Objective : Intracranial tumors represent a heterogeneous group of primary tumors linked by their location.

They have different histological features, biological behavior, etiological factors and variable clinical presentation.

Neuroimaging plays a significant role in lesion detection, localization of the tumor provide a reasonable differential diagnosis, and guide further diagnostic and therapeutic interventions.

The aim of this study was to assess the efficiency of MRI in the diagnosis of supratentorial gliomas in comparison with histopathological findings.

Methods: This is a prospective case series study carried in the radiology department in Rizgary Teaching Hospital-Erbil and Al-Jamhorii Teaching Hospital in a period extends between September 2013 and April 2014.

Patients with MRI supratentorial gliomas prior to biopsy, radiation therapy or surgical procedures were only included in this study.

Accordingly, 32 cases of intra-axial supratentorial tumors were collected with their clinicoradiological data.

Tumors were sent to histopathological typing and grading according to the WHO 2007 central nervous system tumor classification.

Results: The mean age of supratentorial gliomas was 38.29±20.20 years with a median of 41.5 years.

Two peaks of age, the fifth and sixth decades were commonly affected.

A ratio of 1.13:1 was male to female.

Headache was the main clinical presentations, followed by focal neurological deficit (62.67% and 40.35%, respectively).

Temporoparietal region was the commonest site of affection (28.12%), followed by frontopariretal region (15.62%).

All supratentorial gliomas were hyperintense on T2WI while 2/3 rd of them were hypointense in T1WI.

In FLAIR, tumors were isointense in 48.6%.

Glioblastomas represent the highest group of heterogeneity (83.3%) with 65.6% of the gliomas were complex (solid and cystic) components.

Marked and moderate degree of edema with mass effect were common findings among the high-grade gliomas (71.8%) with high statistic significance.

Low grade gliomas have either faint or no enhancement, whereas high-grade tumors were either heterogenous or irregular ring enhencement.

The MRI results were compatible with the histopathological diagnosis in nearly all cases, particullarly the low-grade gliomas.

Conclusions: MRI sensitivity reached up to 100% and the positive predective value was 96.8%.

Conventional MRI using T1WI (pre- and post-contrast), T2WI and flair sequences plays an essential clinical role in diagnosis, localization, and characterization of supratentorial gliomas.