Differential diagnosis by unenhanced FLAIR T2-weighted magnetic resonance images between solitary high grade gliomas and cerebral metastases appearing as contrast-enhancing cortico-subcortical lesions.
The aim was to assess the value of unenhanced fluid-attenuated inversion recovery T2-weighted sequences (FLAIR-T2) in the differential diagnosis between solitary high-grade gliomas (HGG) and cerebral metastases (CM) appearing as contrast-enhancing cortico-subcortical lesions of the brain. In 69 patients with a contrast-enhancing cortico-subcortical brain lesion (43 HGG, and 26 CM), unenhanced FLAIR-T2 and gadolinium-enhanced FLAIR T1-weighted (Gd-FLAIR-T1) axial images have been reviewed for the involvement of the cortex adjacent to the contrast-enhancing lesion. In 27 (62.79%) out of 43 HGG, and 3 (11.53%) out of 26 CM, the cortex adjacent to the contrast-enhancing lesion showed high signal intensity on unenhanced FLAIR-T2 without enhancement at Gd-FLAIR-T1. Fischer's exact probability test was P = 0.0003 when applied to HGG versus CM categories, indicating a significant difference. The high signal intensity on unenhanced FLAIR-T2 without gadolinium-enhancement of the cortex adjacent to the enhancing lesion is more frequently associated with HGG than CM.
Unit of Neuroradiology, Department of Neurosciences, Azienda Ospedaliera di Rilievo Nazionale "Gaetano Rummo", Via dell'Angelo, 1, 82100 Benevento, Italy. cfmuccio@yahoo.it
Carmine Franco
CF
Muccio
Annachiara
A
Tarantino
Gennaro
G
Esposito
Alfonso
A
Cerase
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D019786:Gadolinium DTPA; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D019786:Gadolinium DTPA