Article Figures & Data
Figures
- FIG 1.
Comparison of 7T SWI and 3T MR imaging. Displacement of the corticomedullary junction, seen as a hypointense band (triangles), and elongation of medullary veins running perpendicular to the cortical surface (brackets) can be observed on 7T SWI (spatial resolution, 0.156 × 0.156 × 3 mm; total scan time, 3 minutes and 48 seconds; number of slices, 5) (A), which cannot be appreciated on 3T SWI (0.653 × 0.653 × 2 mm; 4 minutes and 12 seconds; 64 slices) (B), 3T T1-weighted images (C), or 3T FLAIR images (D) obtained on a 3T clinical scanner. Apparent cortical thickening was observed in this diffuse astrocytoma, giving the impression of an oligodendroglioma. However, on close inspection, tapering of the cortex is observed at the edges of the lesion (A, arrows).
- FIG 2.
7T SWI characteristics of astrocytic and oligodendroglial lesions. Astrocytic lesions (A) were predominantly located in the WM and displayed infiltrative growth and focal obscuring of the corticomedullary junction (arrow) without displacing medullary vessels and other normal structures on 7T SWI (B). An oligodendroglioma (WHO grade II) with classic perinuclear halos and chicken wire-like vessels (C) shows thickening of the cortex (triangles), elongation but not thickening of the medullary vessels of the cortex, and expansive growth, displacing the medullary vessels on 7T-SWI (D). Scoring yielded a significant difference between astrocytomas and oligodendrogliomas (mean −1.93 versus +1.71, P < .01) (E). In a case of anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted, diffuse thickening of the cortex without tapering, thickening of medullary vessels, and microbleeds were observed (F). Scale bars = 50 µm. DA/AA/GBM indicates diffuse astrocytoma/anaplastic astrocytoma/glioblastoma; OD/AOD, oligodendroglioma/anaplastic oligodendroglioma.
- FIG 3.
Malignancy scoring of gliomas. A diffuse astrocytoma, IDH mutant (WHO grade II) with a malignancy score of 0 (A), and a glioblastoma, IDH wild-type (WHO grade IV) with a malignancy score of 3, with evidence of thickening of medullary vessels (bracket), microbleeds (arrows) and necrosis (surrounded by triangles) (B). Malignancy scoring was significantly elevated in WHO grade III tumors compared with grade II (mean, 1.38 versus 0.20, P < .01), and grade IV tumors compared with grade III (mean, 2.79 versus 1.38, P < .01) and grade II (P < .01) (C).
- FIG 4.
A diffuse astrocytoma, IDH-mutant, displaying thickening of the cortex with elongation of medullary vessels (arrows) and expansive growth on 7T MR imaging, mimicking an oligodendroglioma (A). Morphologically, the tumor displayed predominantly oligodendroglioma-like pathology (B). Fluorescence in situ hybridization (FISH) revealed 1p-intact (C), 19q-loss (D). ATRX staining was lost in tumor cells (E), and P53 was immunopositive (>10% positive) (F), suggesting astrocytic lineage. Scale bars = 100 µm. Circles indicate individual tumor cells.
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