0:00

So here is another example.

0:02

In fact, a 65-year-old male patient presented

0:07

with headaches and neurological deficits.

0:12

Now this one looked like, you know, it's an

0:15

infiltrative lesion in the right parietal lobe.

0:19

You can see on the T2-weighted images.

0:22

And also on the FLAIR-weighted images.

0:24

And if I show you the post-contrast, uh,

0:28

this tumor is showing some patchy and

0:31

nodular areas of enhancement within this

0:34

lesion, uh, and also, uh, MR perfusion.

0:38

You can see the CBV maps.

0:40

This tumor has increased blood volume,

0:43

almost, uh, looks like that this

0:45

is going to be an aggressive tumor.

0:47

Um, based on the age of now, one more

0:51

important thing to understand in these

0:53

cases, it's always a good idea to

0:55

look at the CT scan if it's available.

0:58

And this tumor clearly showed areas of

1:01

calcification, as you can see on the CT scan.

1:06

And that becomes an important aspect, uh,

1:09

because not many glioblastomas or aggressive

1:12

IDH wild-type gliomas will show calcification.

1:14

Um, Once we see calcification, even though

1:17

it's a little bit older individual, uh, this

1:21

and also showing increased blood volume.

1:23

Uh, we still consider an oligodendroglioma.

1:27

The reason being oligodendrogliomas, even if

1:30

they're low-grade, they can show increased blood

1:33

volume because of the chicken wire vasculature.

1:36

And, uh, they have, and this one turned

1:38

out to be actually an oligodendroglioma,

1:41

which occur mostly in younger individuals,

1:43

but can also be seen in the 5th or 6th decade.

1:47

Um, and, and can have calcification and

1:51

enhancement as well as increased blood volume.

1:54

And this one turned out to be a grade three

1:56

oligodendroglioma, uh, but having said that

1:59

even lower-grade or grade two oligodendrogliomas

2:02

can have increased blood volume on imaging.