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Multiple glioblastomas: CT and MR features.

F Lafitte1, S Morel-Precetti, N Martin-Duverneuil

  • 1Service de Neuroradiologie Charcot, H pital de La Salpétrière, Paris, France.

European Radiology
|February 24, 2001
PubMed
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This study analyzed CT and MR imaging for multiple glioblastomas. MRI is recommended for initial diagnosis due to its ability to reveal lesion heterogeneity and characteristic enhancement patterns.

Area of Science:

  • Neuroradiology
  • Oncology
  • Medical Imaging

Background:

  • Multiple glioblastomas are rare but important differential diagnoses for multiple brain lesions.
  • Distinguishing multiple glioblastomas from other pathologies like metastases is crucial for appropriate patient management.

Purpose of the Study:

  • To analyze computed tomography (CT) and magnetic resonance (MR) imaging features of multiple glioblastomas.
  • To determine the optimal imaging modality for the initial diagnosis of multiple glioblastomas.

Main Methods:

  • Retrospective review of CT (4 exams) and MR imaging (8 exams) in 8 patients with pathologically confirmed multiple glioblastomas.
  • Evaluation of imaging features including lesion density/intensity, edema, mass effect, and contrast enhancement patterns by two neuroradiologists.

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Main Results:

  • Lesions were consistently hypo/isodense on CT and hyperintense on T2-weighted MR images.
  • T1-weighted images showed hypo/isointensity in 90% of cases; enhancement was strong (71% CT, 70% MR), often heterogeneous or ring-like.
  • MR imaging demonstrated varied patterns across lesions within the same patient (75% of cases); meningeal/ventricular enhancement was rare.

Conclusions:

  • Multiple glioblastomas should be considered in the differential diagnosis of multiple cerebral masses, alongside metastases, abscesses, and lymphomas.
  • Moderate edema and mass effect on MR, with strong, heterogeneous enhancement, are suggestive features of multiple glioblastomas.
  • MR imaging is valuable for characterizing multiple glioblastomas, though routes of dissemination are rarely visualized.