Cerebrovascular Disease
The diagnostic significance of hyperintense fluid-attenuated inversion-recovery rim signal for isocitrate dehydrogenase mutant 1p/19q non-codeleted astrocytoma
Li Mingxiao, Chen Xuzhu, Shen Shaoping, Yang Chuanwei, Zhang Xiaokang, Cui Yong, Ren Xiaohui, Lin Song
Published 2022-09-28
Cite as Chin J Neurosurg, 2022, 38(9): 873-877. DOI: 10.3760/cma.j.cn112050-20211005-00489
Abstract
ObjectiveTo investigate the diagnostic significance of hyperintense fluid-attenuated inversion-recovery (FLAIR) rim (hyperFLAIRrim) sign for isocitrate dehydrogenase (IDH) mutant 1p/19q non-codeleted (IDHmut-Noncodel) astrocytoma.
MethodsA total of 585 lower-grade glioma (LGG) (World Health Organization grade 2-3) patients who received craniotomy at the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from December 2013 to December 2020 were included in this study and their clinical data were retrospectively analyzed. The sensitivity and specificity of T2-FLAIR mismatch and hyperFLAIRrim sign were evaluated. Besides, calcification information was assessed for subgroup analysis. The application value was further determined combined with the calcification information.
ResultsIn 585 qualified patients, 71.3% (186/261)of IDHmut-Noncodel astrocytomas were hyperFLAIRrim positive, and hyperFLAIRrim sign was absent in oligodendrogliomas and IDH wild-type LGGs. The sensitivity for T2-FLAIR mismatch and hyperFLAIRrim sign was 0.52 and 0.71, respectively, and the specificity was 1.00 for both. For all calcific tumors, 85.8% (115/134) were oligodendroglioma. And the sensitivity of T2-FLAIR mismatch and hyperFLAIRrim sign in non-calcific tumors was 0.54 and 0.74, respectively, and the specificity of 1.00 for both.
ConclusionsThe hyperFLAIRrim sign seems more sensitive for IDHmut-Noncodel astrocytoma without compromised specificity. Combining calcification could further improve the diagnosis sensitivity.
Key words:
Astrocytoma; Dignosis; Hyperintense fluid-attenuated inversion-recovery rim; T2-fluid-attenuated inversion-recovery mismatch; Isocitrate dehydrogenase mutation
Contributor Information
Li Mingxiao
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Chen Xuzhu
Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Shen Shaoping
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Yang Chuanwei
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Zhang Xiaokang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Cui Yong
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Ren Xiaohui
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
Lin Song
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
