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- MRI Features to Differentiate Between Ring-Enhancing Gliomas and Brain Abscesses: A Multicenter Study
MRI Features to Differentiate Between Ring-Enhancing Gliomas and Brain Abscesses: A Multicenter Study
VRU 63(5): 563-572
Andrea Carloni, Marco Bernardini, Chiara Mattei, Angela Vittoria De Magistris, Francisco Llabres-Diaz, Jonathan Williams, Rodrigo Gutierrez-Quintana, Anna Oevermann, Daniela Schweizer-Gorgas, Cyrielle Finck, Isabelle Masseau, Valentina Lorenzo, Annalisa Sabatini, Barbara Contiero, Swan SpecchiAndrea Carloni, Marco Bernardini, Chiara Mattei, Angela Vittoria De Magistris, Francisco Llabres-Diaz, Jonathan Williams, Rodrigo Gutierrez-Quintana, Anna Oevermann, Daniela Schweizer-Gorgas, Cyrielle Finck, Isabelle Masseau, Valentina Lorenzo, Annalisa Sabatini, Barbara Contiero, Swan Specchi
Method: The study was a multicenter, retrospective, and observational study. The inclusion criteria were: a definitive diagnosis of glioma or abscess based on cytological or histopathological examination following CSF collection or surgical biopsy/necropsy; an MRI study performed with a high- or low-field MRI scanner. Sixteen patients were diagnosed with ring-enhancing gliomas and 15 were diagnosed with intra-axial abscesses.
Results: The study found that brain abscesses showed a more homogeneous signal on T1W and T2W sequences than ring-enhancing gliomas. A peripheral hypointense halo on T2W and T2*W GE sequences was significantly associated with brain abscesses rather than ring-enhancing gliomas. On postcontrast T1W sequences, abscesses showed a more even ring-enhancing capsule compared to ring-enhancing gliomas. Ring-enhancing gliomas were more likely to have a progressive central enhancement on T1W delayed postcontrast sequences.
Conclusions: The study concluded that even if several overlapping MRI features between ring-enhancing gliomas and brain abscesses exist, some features can help to prioritize the MRI diagnosis. The presence of a homogeneous T1W or T2W signal intensity, a T2W or T2*W GE peripheral hypointense halo and an even enhancing capsule may indicate a brain abscess. The central progression of the enhancement on delayed postcontrast T1W sequences is indicative of glial neoplasia
Immediate postcontrast T1W transverse (A) and dorsal delayed postcontrast T1W (B) images (1.5 T, transverse T1W FSE TR 500, TE 13) of a 9-year-old male neutered, DLH cat with a right temporo-parietal lobe abscess secondary to a bite wound with temporal myopathy (arrows). Despite the different acquisition planes, the thickness of the abscess capsule does not increase over time (white arrowheads). Immediate postcontrast T1W FLAIR (C) and delayed postcontrast T1W FLAIR (D) transverse images (1.5 T, transverse T1W FLAIR FSE TR 2560, TE 26, TI 1013) of a 9-year-old, female spayed, Labrador Retriever with a left cerebellar ring-enhancing glioma. Note the conspicuous central progression (black arrowheads) of the enhancement on the delayed postcontrast sequence
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