CT and MR Features of Multiple Gliomas

Abstract

We analysed the CT and MR features of multiple gliomas, and determined the best imaging modality for the initial diagnosis. CT (seven scans) and MR imaging (nine scans) of nine patients with proven multifocal malignant gliomas were reviewed by two neuroradiologists. The lesions were usually hypodense on CT (64%), hypo or isointense on T1-W images (81%), and hyperintense on T2-W images (95%). Edema and mass effect were usually moderate or absent.

After contrast media administration, the enhancement was mostly strong (64% on CT and 81% on MR), often heterogenous. MR features of the different lesions in one patient were often different (67%). Meningeal enhancement, suggestive of a possible way of dissemination, was rare. MR allowed detection of six lesions overlooked by CT. In the case of multiple cerebral masses, multiple gliomas should be considered as a possible diagnosis as well as brain metastases, abcesses or multifocal lymphomas. Moderate edema and mass effect associated with strong and heterogenous enhancement are evocative. MR is more sensitive than CT for the detection of the lesions, but rarely allows visualization of a dissemination route.