Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
15 topics, 1 hr. 37 min.
Introduction to Adult Glioma Imaging
1 m.WHO Glioma Classification Update and Important Genetic Markers
16 m.Primary IDH Wild Type Glioma
3 m.IDH Wild Type Gliomas
12 m.IDH Mutant Gliomas
23 m.IDH Mutant Oligodendroglioma, Grade 2
2 m.Grade 3 Oligodendroglioma
3 m.BRAF and H3K27 Gliomas
12 m.H3K27 Glioma
3 m.T2 FLAIR Mismatch Sign
8 m.T2 FLAIR Mismatch Sign, Astrocytoma – 31 y/o Female
2 m.T2 FLAIR Mismatch Sign, Astrocytoma – 28 y/o Male
1 m.IDH Mutant Astrocytoma, No Mismatch Sign
2 m.CNS Lymphoma
4 m.Approach to Intra Axial Tumors: Tumor Mimics, Non Neo-plastic Lesions
12 m.0:00
So here is a 31-year-old female
0:02
presenting with headaches.
0:04
And the MRI shows a rather well-defined
0:09
mass in the right medial temporal lobe.
0:12
And you can see that the tumor is
0:15
kind of homogeneously bright,
0:17
very well-defined on T2 two weighted images.
0:20
But more importantly is majority of the tumor is
0:24
dark in the central part on the FLAIR images,
0:27
except this thin peripheral bright
0:29
rim on the FLAIR images.
0:31
And this is what we call a T2 FLAIR mismatch sign.
0:35
And typically, these tumors also do not
0:39
show any enhancement.
0:39
As you can see,
0:40
there is no enhancement
0:42
on the post-contrast images.
0:43
And majority of these tumors also show very
0:47
facilitated diffusion in this
0:49
central portion of the tumor,
0:51
which is almost gelatinous
0:54
and very soft on surgery.
0:57
Neurosurgeons will classically
0:59
tell you that these are
1:00
gelatinous soft tumors,
1:01
which are very easy to resect.
1:03
And this is what we have described
1:07
as the T2 FLAIR mismatch sign.
1:09
A classic example in a younger patient.
1:12
And once we see this sign,
1:13
we know that this tumor is going to be IDH-mutated
1:17
non-codeleted astrocytoma.
1:20
And this is one example over here.
Interactive Transcript
0:00
So here is a 31-year-old female
0:02
presenting with headaches.
0:04
And the MRI shows a rather well-defined
0:09
mass in the right medial temporal lobe.
0:12
And you can see that the tumor is
0:15
kind of homogeneously bright,
0:17
very well-defined on T2 two weighted images.
0:20
But more importantly is majority of the tumor is
0:24
dark in the central part on the FLAIR images,
0:27
except this thin peripheral bright
0:29
rim on the FLAIR images.
0:31
And this is what we call a T2 FLAIR mismatch sign.
0:35
And typically, these tumors also do not
0:39
show any enhancement.
0:39
As you can see,
0:40
there is no enhancement
0:42
on the post-contrast images.
0:43
And majority of these tumors also show very
0:47
facilitated diffusion in this
0:49
central portion of the tumor,
0:51
which is almost gelatinous
0:54
and very soft on surgery.
0:57
Neurosurgeons will classically
0:59
tell you that these are
1:00
gelatinous soft tumors,
1:01
which are very easy to resect.
1:03
And this is what we have described
1:07
as the T2 FLAIR mismatch sign.
1:09
A classic example in a younger patient.
1:12
And once we see this sign,
1:13
we know that this tumor is going to be IDH-mutated
1:17
non-codeleted astrocytoma.
1:20
And this is one example over here.
Report
Description
Faculty
Rajan Jain, MD
Professor of Radiology and Neurosurgery
New York University Grossman School of Medicine
Tags
Oncologic Imaging
Neuroradiology
Neoplastic
MRI
Brain
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