Radiological Evaluation of Infratentorial Gangliogliomas in Various Anatomic Locations of the Cerebellum and Brainstem

Zhang, S.; Lin, Aiming; Chen, X. Z.; Wang, K.

doi:10.1007/s00062-015-0495-7

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…(11) reported the ipsilateral cerebellar atrophy in 7/9 patients with PXA; in the study by Zhang et al. (18), 33.3% (8/24) of patients demonstrated cortical atrophy. Consistent with previous studies (11,18), ipsilateral cerebellar atrophy was found in 5/12 gangliogliomas, whereas none of the pilocytic astrocytoma in our series showed this feature.…”

Section: Discussionmentioning

confidence: 94%

“…(18), 33.3% (8/24) of patients demonstrated cortical atrophy. Consistent with previous studies (11,18), ipsilateral cerebellar atrophy was found in 5/12 gangliogliomas, whereas none of the pilocytic astrocytoma in our series showed this feature. The mechanism of cerebellar atrophy for infratentorial ganglioglioma remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…However, most conventional MRI features such as cystic change, degree of enhancement, and peritumoral edema cannot reliably distinguish infratentorial ganglioglioma and pilocytic astrocytoma in our study, both of which may have a contrast-enhancing solid-cystic mass imaging finding considered characteristic for pilocytic astrocytoma. Ipsilateral cerebellar atrophy has been reported to be a relatively specific feature for infratentorial ganglioglioma (11,18). Lou et al.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of conventional, diffusion, and perfusion MRI between infratentorial ganglioglioma and pilocytic astrocytoma

She

Xiong

et al. 2019

Acta Radiol

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Background The differentiation of infratentorial ganglioglioma and pilocytic astrocytoma may be therapeutically relevant, which is sometimes challenging to both pathologists and neuroradiologists. Purpose To evaluate the conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and dynamic susceptibility contrast-enhanced perfusion weighted imaging (DSC-PWI) features of infratentorial ganglioglioma compared with pilocytic astrocytoma. Material and Methods This retrospective study enrolled 12 patients with infratentorial ganglioglioma and 61 patients with pilocytic astrocytoma who underwent MRI before surgery. DSC-PWI was performed in 20 patients (4 gangliogliomas, 16 pilocytic astrocytoma). Demographics, conventional imaging characteristics (tumor location, margin, cystic change, enhancement, peritumoral edema, and ipsilateral cerebellar atrophy), rADCmin, and rCBVmax ratio were compared. The optimum threshold, sensitivity, and specificity for rADCmin and rCBVmax ratios were determined. Results Infratentorial ganglioglioma appeared similar to pilocytic astrocytoma but was more likely to have an ill-defined margin (P = 0.035), ipsilateral cerebellar atrophy (P < 0.001), lower rADCmin ratio (1.24 ± 0.27 vs. 2.04 ± 0.46, P < 0.001), and higher rCBVmax ratio (3.05 ± 1.12 vs. 1.64 ± 0.39; P = 0.008). The threshold values ≤1.66 for rADCmin ratio provide sensitivity and specificity of 91.67% and 77.05%, respectively, for discriminating ganglioglioma from pilocytic astrocytoma. The optimal threshold value for rCBVmax ratio was >1.64. Conclusion Conventional MRI, DWI, and DSC-PWI can help to differentiate infratentorial ganglioglioma from pilocytic astrocytoma. DWI offers optimal sensitivity.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of conventional, diffusion, and perfusion MRI between infratentorial ganglioglioma and pilocytic astrocytoma

She

Xiong

et al. 2019

Acta Radiol

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“…11 There are also documented imaging features associated with molecular subgroups, as SHH involves the cerebellar hemisphere, the WNT pathway involves cerebellar peduncle/cerebellopontine cistern, group 3 tumours are ill-defined on imaging and group 4 tumours have minimal or no enhancement. 7,10–12 In this case, the brainstem location of the tumour without any relationship with fluid-filled spaces does not correlate with these statements.…”

Section: Discussionmentioning

confidence: 63%

“…8 It was mentioned as an important diagnostic clue for the ipsilateral cerebellar atrophy associated with infra-tentorial gangliogliomas in cases where middle or inferior peduncles are involved, although it may exist in other situations, as with the presented case. 6,7,9,10 In contrast to children, the most common molecular subtypes in adults are the activated SHH, activated WNT and group 4 subgroups. Previous studies showed that the SHH and WNT subgroups correlate with the site of origin of these tumours.…”

Section: Discussionmentioning

confidence: 99%

Primary Sonic Hedgehog–activated dorsal brainstem medulloblastoma and ipsilateral cerebellar atrophy in an adult

et al. 2019

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Medulloblastoma (MB) that arises outside the cerebellum from cells of the dorsal brainstem is rare. The most common subtype of MB in the dorsal brainstem is the Wingless (WNT) subtype that contains activating mutations in the WNT pathway effector CTNNB1. Ipsilateral cerebellar hemi-atrophy with a brainstem tumour is a finding that is usually documented with brainstem gangliogliomas as a possible specific imaging sign. We present a case of a 23-year-old female with progressive headache, imbalance on walking, double vision and difficulty in swallowing for a year. Magnetic resonance imaging demonstrated a mass with prominent restricted diffusion on the dorsal surface of the lower brainstem with ipsilateral cerebellar atrophy. The final histopathological diagnosis was a Sonic Hedgehog (SHH)-activated and TP53 wild-type primary lower dorsal brainstem MB. Primary SHH-activated TP53 wild-type dorsal brainstem MB is extremely rare, and as far as we know, the association of the tumour with ipsilateral cerebellar hemi-atrophy in an adult has never been reported. MB should be included in the differential diagnosis of focal dorsal brainstem tumours, even in the presence of ipsilateral cerebellar hemi-atrophy.

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Ganglioglioma

Dorfer¹

2019

Oncology of CNS Tumors

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Radiological Evaluation of Infratentorial Gangliogliomas in Various Anatomic Locations of the Cerebellum and Brainstem

Cited by 7 publications

References 23 publications

Comparison of conventional, diffusion, and perfusion MRI between infratentorial ganglioglioma and pilocytic astrocytoma

Comparison of conventional, diffusion, and perfusion MRI between infratentorial ganglioglioma and pilocytic astrocytoma

Primary Sonic Hedgehog–activated dorsal brainstem medulloblastoma and ipsilateral cerebellar atrophy in an adult

Ganglioglioma

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