Document Detail


Perfusion MR imaging and proton MR spectroscopic imaging in differentiating necrotizing cerebritis from glioblastoma multiforme.
MedLine Citation:
PMID:  17275620     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We describe a lesion with the magnetic resonance imaging (MRI) characteristics of a glioblastoma mutiforme and demonstrate how perfusion MRI and proton MR spectroscopic imaging can be used to differentiate necrotizing cerebritis from what appeared to be a high-grade glioma. A 43-year-old woman presented to her physician complaining of progressive visual disturbance and headache for several weeks. Conventional MRI demonstrated a parietal peripherally enhancing mass with central necrosis and moderate to severe surrounding T2 hyperintensity, suggesting an infiltrating high-grade glioma. However, advanced imaging, including dynamic susceptibility contrast MRI (DSC MRI) and magnetic resonance spectroscopic imaging (MRSI), suggested a nonneoplastic lesion. The DSC MRI data demonstrated no hyperperfusion within the lesion and surrounding T2 signal abnormality, and the MRSI data showed overall decrease in metabolites in this region, except for lactate. Because of the aggressive appearance to the lesion and the patients' worsening symptoms, a biopsy was performed. The pathologic diagnosis was necrotizing cerebritis. After the commencement of steroid therapy, imaging findings and patient symptoms improved. This report will review the utility of advanced imaging for differentiating inflammatory from neoplastic appearing lesions on conventional imaging.
Authors:
Gabriel Pivawer; Meng Law; David Zagzag
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-11-20
Journal Detail:
Title:  Magnetic resonance imaging     Volume:  25     ISSN:  0730-725X     ISO Abbreviation:  Magn Reson Imaging     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-05     Completed Date:  2007-04-03     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  8214883     Medline TA:  Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  238-43     Citation Subset:  IM    
Affiliation:
Department of Radiology, NYU Medical Center, New York, NY 10016, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Neoplasms / diagnosis
Contrast Media
Diagnosis, Differential
Encephalitis / diagnosis*
Female
Gadolinium DTPA / diagnostic use
Glioblastoma / diagnosis
Humans
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging / methods*
Magnetic Resonance Spectroscopy / methods*
Necrosis
Grant Support
ID/Acronym/Agency:
R01 CA111996-01A1/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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