Can MRI differentiate between ring-enhancing gliomas and intra-axial abscesses?

Carloni, Andrea; Bernardini, Marco; Mattei, Chiara; De Magistris, Angela Vittoria; Llabres-Diaz, Francisco; Williams, Jonathan; Gutierrez-Quintana, Rodrigo; Oevermann, Anna; Schweizer-Gorgas, Daniela; Finck, Cyrielle; Masseau, Isabelle; Lorenzo, Valentina; Sabatini, Annalisa; Contiero, Barbara; Specchi, Swan (2022). Can MRI differentiate between ring-enhancing gliomas and intra-axial abscesses? Veterinary radiology & ultrasound, 63(5), pp. 563-572. Wiley 10.1111/vru.13098

Text Vet_Radiology_Ultrasound_-_2022_-_Carloni_-_Can_MRI_differentiate_between_ring_enhancing_gliomas_and_intra_axial_abscesses.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (1MB) | Request a copy

Gliomas of the brain may appear as expansile ring-enhancing masses in MRI studies, mimicking the appearance of intra-axial abscesses. The aims of this study were to compare the MRI features of ring-enhancing gliomas and intra-axial brain abscesses in dogs and cats and to identify the characteristics that might help differentiate them. For this multicenter, retrospective, and observational study, the inclusion criteria were as follows: (a) a definitive diagnosis of glioma or abscess based on cytological or histopathological examination following CSF collection or surgical biopsy/necropsy, respectively; (b) MRI study performed with a high- or low-field MRI scanner, including a same plane T1W pre- and postcontrast, a T2W and a T2 FLAIR sequence in at least one plane. If available, delayed T1W postcontrast, T2*W GE, DWI/ADC, and SWI sequences were also evaluated. Sixteen patients were diagnosed with ring-enhancing gliomas, and 15 were diagnosed with intra-axial abscesses. A homogenous signal on T1W (P = 0.049) and T2W (P = 0.042) sequences, a T2W (P = 0.005) or T2*W GE (P = 0.046) peripheral hypointense halo, and an even enhancing capsule (P = 0.002) were significantly associated with brain abscesses. A progressive central enhancement on delayed T1W postcontrast sequences was correlated with ring-enhancing gliomas (P = 0.009). The combination of the following features was suggestive of brain abscess: homogeneous T1W or T2W signal intensity, a T2W or T2*W GE peripheral hypointense halo and an evenly enhancing capsule. Central progression of enhancement on delayed T1W postcontrast sequences was suggestive of glioma.

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