Article Figures & Data
Figures
- Fig 1.
Typical MR imaging of EBL (patient 11), presenting as large hemispheric tumor mass. Note the well-delineated tumor margins and absence of surrounding edema. MR signal intensity is high in T2WI (A) and iso- to hypointense in T1WI (B). The tumor shows moderate enhancement of some parts after gadolinium administration (C). ADC map shows low signal (D, see also Fig 5B). Single-voxel MR spectroscopy (E) of the tumor with a choline:NAA ratio of 5:1, indicating high cellularity. There is a small peak for lactate at 1.3 ppm. A signal for lipids was not detected in this case (3T Trio; Siemens, Erlangen, Germany).
- Fig 2.
Infratentorial EBL (patient 7) of the fourth ventricle with marked displacement of the brain stem (A). T2 signal is predominantly inhomogeneous. No surrounding edema is present (B). Methemoglobin as a sign of intratumoral hemorrhage (white arrow in C). This tumor does not enhance after contrast administration (D) (1.5T Symphony; Siemens).
- Fig 3.
Hemispheric EBL (patient 6) with inhomogeneous signal and moderate contrast enhancement (yellow arrow in A). Cystic components of variable size are present in the tumor (white arrows in A and B). Small peritumoral edema can be found in T2WI (white arrowhead in B). Note there is significant mass effect with midline shift. Tumor margins are less defined in some areas compared with patient 11 (Fig 1) (1.5T Symphony; Siemens).
- Fig 4.
Small parasagittal EBL (patient 15) with predominantly homogeneous, isointense MR signal in T2WI (A, black arrow) and T1WI (B). Note there is diffusion restriction (D), but no intratumoral contrast enhancement (C) (1.5T Signa Excite; GE Healthcare, Milwaukee, Wisconsin).
- Fig 5.
Left hemispheric EBL of patient 5 showing restricted diffusion (black asterisk in A) with corresponding low signal in ADC map (white asterisk in B), reflecting diffusion restriction and high cellularity. This finding was observed in every patient with EBL of our cohort (3T Verio; Siemens).
- Fig 6.
T2WI of 2 EBLs with corresponding CT scans of patient 12 (A, B) and patient 19 (C, D). Note almost T2 isointense signal of the tumor in (A) with slight hyperattenuation in the corresponding CT image (B). This tumor is indicative of higher cellularity, compared with the EBL shown in (C) and (D). Calcifications such as in (D) can complicate the detection of components with high cellularity. Region of interest in red showing Hounsfield units of tumors, normal cortex, and calcifications (A, 1.5T Signa Excite, GE Healthcare; B, Sensation 16, Siemens; C, 0.5T NT Intera, Philips Healthcare, Best, the Netherlands; D, Lightspeed Plus, GE Healthcare).
- Fig 7.
Typical histopathologic finding of EBL (patient 1) with ependymoblastic rosettes (black arrows).
