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Updated: Jun 12, 2026
Translational Orthotopic Models of Glioblastoma Multiforme
Published on: February 17, 2023
A unique magnetic resonance imaging feature of glioblastoma multiforme: the 'pseudopalisade' sign
1Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China. hbc9209@163.com
Abstract:
This study was designed to investigate the unique magnetic resonance imaging (MRI) appearance of histopathologically-proven glioblastoma multiforme (GBM) with pseudopalisade necrosis and to assess its value for grading gliomas and providing a differential diagnosis. The study included 169 patients with intracranial masses who underwent surgery and had a proven histopathological diagnosis: 50 with GBM, 77 with gliomas (46 grade II and 31 grade III) and 42 with other intracranial masses (20 metastases, 14 lymphomas and eight abscesses). All patients underwent preoperative brain MRI including post-contrast T(1)-weighted imaging. The presence of the 'pseudopalisade' sign on post-contrast T(1)-weighted images was compared among the different types of brain mass. The frequency of the 'pseudopalisade' sign in GBMs (94.00%) was significantly higher than that seen in grade II and III gliomas (11.69%) and other intracranial masses (7.14%). The 'pseudopalisade' sign on post-contrast T(1)-weighted images was useful for grading gliomas and for differentiating GBM from other brain masses.
Insights
The pseudopalisade sign on MRI is highly indicative of glioblastoma multiforme (GBM). This imaging finding aids in distinguishing GBM from other brain tumors and grading gliomas.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Glioblastoma multiforme (GBM) is an aggressive primary brain tumor.
- Accurate grading and differential diagnosis of intracranial masses are crucial for patient management.
- The 'pseudopalisade' sign is a recognized, though not fully characterized, imaging feature.
Purpose of the Study:
- To investigate the magnetic resonance imaging (MRI) appearance of glioblastoma multiforme (GBM) with pseudopalisade necrosis.
- To evaluate the utility of the 'pseudopalisade' sign for glioma grading.
- To assess its value in the differential diagnosis of intracranial masses.
Main Methods:
- Retrospective analysis of 169 patients with histopathologically confirmed intracranial masses.
- Preoperative brain MRI, including post-contrast T1-weighted imaging, was performed on all patients.
- Comparison of the frequency of the 'pseudopalisade' sign across GBM, other gliomas (grades II and III), and non-glial masses (metastases, lymphomas, abscesses).
Main Results:
- The 'pseudopalisade' sign was identified in 94.00% of GBM cases.
- The sign was significantly less frequent in grade II and III gliomas (11.69%) and other intracranial masses (7.14%).
- A statistically significant difference in the frequency of the 'pseudopalisade' sign was observed between GBM and other lesion types.
Conclusions:
- The 'pseudopalisade' sign on post-contrast T1-weighted MRI is a highly sensitive indicator for glioblastoma multiforme.
- This imaging feature is valuable for differentiating GBM from lower-grade gliomas and other intracranial pathologies.
- The 'pseudopalisade' sign aids in improving the accuracy of glioma grading and differential diagnosis.
