Original ArticlesThe Significance of Lack of MR Contrast Enhancement of Supratentorial Brain Tumors in Adults: Histopathological Evaluation of a Series
Section snippets
Subjects and Methods
The database of our brain tumor center was searched to identify adult patients with non-enhancing supratentorial parenchymal neoplasms on preoperative MRI examinations. Cases were collected without consideration of or knowledge of diagnosis. Cases were included in this study if either 1) we had the actual scan documenting lack of enhancement (these scans were reviewed by a senior neuroradiologist) or 2) there was a radiology report on file attesting to the lack of enhancement on a preoperative
Results
Non-enhancing lesions arose in the following locations: frontal lobe (13), hypothalamus (1), parietal lobe (4), frontoparietal region (4), temporal lobe (6), frontotemporal region (2), insula (6), temporoparietal region (2), parieto-occipital region (1), and foramen of Monro (1). Histopathologic examination identified 24 (60%) low-grade gliomas: 4 (10%) low-grade astrocytomas, 10 (25%) low-grade gliomas (infiltrating gliomas for which further subclassification was not possible and lacked
Discussion
Confronted with a probable brain tumor, the neuro-oncologist and neurosurgeon face a vexing clinical management problem. Many factors are considered, including the age and condition of the patient; the patient’s feelings about the various treatment options; and particularly the lesion’s location, imaging appearance, and likely histologic nature. Imaging plays an essential role in the preoperative (and postoperative) workup of brain tumors. The CT and MRI literature are replete with excellent
Acknowledgements
We are grateful to Donna Stevenson for secretarial assistance, Melissa Burkett for editorial assistance, and Dennis Johnston of the Department of Biomathematics for help with the statistical analysis.
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