Astrocytic tumours

Astrocytic tumours are frequent, accounting for nearly 50% of all brain tumours. They are divided into three groups: benign astrocytomas, anaplastic astrocytomas and malignant glioblastomas. The usual clinical manifestations of benign astrocytic tumours are epileptic seizures, whereas those of glioblastomas are rapidly progressing neurological deficits. These lesions show fairly characteristic neuroradiological features which have been largely studied. Injections of iodine-based or paramagnetic contrast media are important since they help in tumour grading: low-grade tumours are not enhanced, while glioblastomas are almost invariably enhanced. MRI seems to be indispensable for the study of astrocytic tumours: it provides an excellent anatomical analysis of the lesion during preoperative or pretherapeutic evaluation, and it is the only available method to confirm low-grade lesions that have passed unnoticed or have merely been suspected at CT. To avoid missing these tumours, every adult presenting with recent onset epileptic seizures should be explored by MRI using T2-weighted spin-echo sequences.