Fig 2.1A: Axial Flair MRI Fig 2.1B: Axial T1 Weighted (Wtd.) MRI Fig 2.

MRI Fig 2.1C: Post-Contrast Axial T1 Wtd. MRI

56 Year-old male with 3

month history of
gradual weakness of
the right upper
extremity.

Diagnosis: ???

Fig 2.1D: Post Contrast Coronal T1 Wtd. MRI Fig 2.1E: Post Contrast Sagital T1 Wtd. MRI
Fig 2.2A: Axial Flair MRI Fig 2.2B: Axial T1 Wtd. MRI Fig 2.2C: Post-Contrast Axial T1 Wtd. MRI

51 Year-old male with

history of seizures and
was involved in a car
accident, leading to
imaging studies.

Diagnosis: ???

Fig 2.2D: Post Contrast Coronal T1 Wtd. MRI

Fig 2.3A: Axial Flair MRI Fig 2.3B: Axial T1 Wtd. MRI Fig 2.3C: Post-Contrast Axial T1 Wtd. MRI

19 Year-old young lady

with seizures and
headache

Diagnosis: ???

Fig 2.3D: Post Contrast Sagital T1 Wtd. MRI

Fig 2.4A: Axial T2 Wtd. MRI Fig 2.4B: Axial T1 Wtd. MRI Fig 2.4C: Post-Contrast Axial T1 Wtd. MRI

12 Year-old boy with

headache, nausea and
vomiting for three months.

Diagnosis: ???

Fig 2.4D: Post Contrast Coronal T1 Wtd. MRI

Fig 2.5A: Axial Flair MRI Fig 2.5B: Axial T1 Wtd. MRI Fig 2.5C: Post-Contrast Axial T1 Wtd. MRI

60 Year-old male with six

month history of gradual
memory loss, disorientation
and headache.

Diagnosis: ???

Fig 2.5D: Post Contrast Coronal T1 Wtd. MRI

Match the
following Gliomas
shown in figs 2.1 Fig. 2.1 A. Butterfuly Glioblastoma
thru 2.5 to WHO
(World Health
Organization)
Classification:

Fig. 2.2 B. Grade 2 Astrocytoma

Fig. 2.3 C. Pilocytic Astrocytoma (Grade 1 Astrocytoma)

Fig. 2.4 D. Glioblastoma (Grade 4 Astrocytoma)

See Next
Panel for
Correct
Fig. 2.5 E. Anaplastic Astrocytoma Grade 3 Answers
Match the
following Gliomas
Correct Answers
shown in figs 2.1 Fig. 2.1
thru 2.5 to WHO D. Glioblastoma (Grade 4 Astrocytoma)

(World Health
Organization)
Classification:

Fig. 2.2 E. Anaplastic Astrocytoma Grade 3

B. Grade 2 Astrocytoma
Fig. 2.3

C. Pilocytic Astrocytoma (Grade 1 Astrocytoma)

Fig. 2.4

Fig. 2.5 A. Butterfuly Glioblastoma

 E

Fig 2.1A: Axial Flair MRI Fig 2.1B: Axial T1 Weighted Fig 2.1C: Post-Contrast Axial T1
(Wtd.) MRI Wtd. MRI

An irregular enhancing ring lesion (arrow) is seen involving the left parietal lobe. Tumor is associated with
edema (E) best noticed on FLAIR image (A).

DIAGNOSIS: GLIOBLASTOMA

• Grade IV Astrocytoma (WHO Classification)

• Older Patient
•Imaging Features: Tumor with irregular peripheral enhancement with central necrosis.
•Median survival is 1 – 2 years following Surgery/Radiation therapy/Chemotherapy.
Fig 2.2A: Axial Flair MRI Fig 2.2B: Axial T1 Wtd. MRI Fig 2.2C: Post-Contrast Axial T1 Wtd. MRI Fig 2.2D: Post Contrast Coronal T1 Wtd. MRI

An ill-defined non-enhancing tumor (yellow arrows) is seen in the left parietal lobe with spotty areas of
enhancement (red arrows).

DIAGNOSIS: Anaplastic Astrocytoma

• Grade III Astrocytoma (WHO Classification)

• Usually seen between 40 – 60 years of age
• Imaging Features: Ill-defined non-enhancing tumor with or without feeble enhancement.
• Median survival is 5 – 6 years following Surgery/Radiation therapy/Chemotherapy.
 Fig 2.3A: Axial Flair MRI Fig 2.3B: Axial T1 Wtd. MRI Fig 2.3C: Post-Contrast Axial T1 Wtd. MRI

Non-enhancing tumor (arrow) involving the right temporal lobe.

DIAGNOSIS: GRADE III ASTROCYTOMA (LOW GRADE)

• Children and young adults

• Imaging Features: Non-enhancing tumors. Calcification can be seen.
• Total cure from surgery to median survival of 7- 10 years.
 Fig 2.4A: Axial T2 Wtd. MRI Fig 2.4B: Axial T1 Wtd. MRI Fig 2.4C: Post-Contrast Axial T1 Wtd. MRI

A large cystic tumor (yellow arrow) with a mural enhancing nodule (red arrow) is seen within the left
cerebellar hemisphere.

DIAGNOSIS: PILOCYTIC ASTROCYTOMA

• Grade I Astrocytoma (WHO Classification)

• Children and young adults
• Imaging Features: cyst within enhancing tumor nodule.
• Surgical resection can result in complete cure.