Computed tomography and magnetic resonance features of gliosarcoma: a study of 54 cases

J Comput Assist Tomogr. 2011 Nov-Dec;35(6):667-73. doi: 10.1097/RCT.0b013e3182331128.

Abstract

Objective: To investigate the features of pathologically confirmed gliosarcomas using computed tomography (CT) and magnetic resonance (MR) imaging.

Methods: We retrospectively reviewed the cross-sectional CT and MR images of 54 patients (37 males and 17 females; mean age, 44.5 years; range, 13-74 years) with gliosarcomas confirmed by histopathology.

Results: Across all patients, there were 59 lesions. On nonenhanced CT and MR images, tumors were predominantly inhomogeneous. On the postcontrast CT and MR images, 50 (84.7%) irregular lesions had thick walls with a strong rim- and ringlike enhancement, whereas the remaining 9 (15.3%) round or oval lesions had even thin walls with an enhanced peripheral ring. Magnetic resonance spectroscopy showed increased choline and lactate values, along with decreased N-acetylaspartate and creatine values. On diffusion-weighted imaging, the tumor was slightly or markedly hyperintense compared with the white matter.

Conclusion: A well-demarcated mass located peripherally, with rimlike or ring enhancement, is a common presentation of gliosarcoma on CT and MR images. In addition, magnetic resonance spectroscopy and diffusion-weighted imaging can be used to make a differential diagnosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aspartic Acid / analogs & derivatives
  • Aspartic Acid / metabolism
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / metabolism
  • Choline / metabolism
  • Contrast Media
  • Creatine / metabolism
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Gadolinium DTPA
  • Gliosarcoma / diagnosis*
  • Gliosarcoma / diagnostic imaging
  • Gliosarcoma / metabolism
  • Humans
  • Iohexol
  • Lactates / metabolism
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Spectroscopy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media
  • Lactates
  • Aspartic Acid
  • Iohexol
  • N-acetylaspartate
  • Gadolinium DTPA
  • Creatine
  • Choline