Multimodal MRI manifestations of diffuse midline glioma, H3 K27M mutant / 中国医学影像技术

ABSTRACT

Objective: To investigate multimodal MRI features of diffuse midline glioma, H3 K27M mutant. Methods Multimodal MRI features, including plain and enhanced MRI, DWI and dynamic susceptibility contrast (DSC)-PWI of 10 patients with pathologically proved diffuse midline glioma, H3 K27M mutant were retrospectively analyzed. The location, size, edema, signal characteristics, diffusion, enhancement characteristics, etc. of the tumors were observed. Results Among 10 patients, 8 lesions located at thalamus, 1 at medulla and cervical cord, 1 at hypothalamus. The mean maximum tumor diameter was (5.56±0.42)cm, and the mean peritumoral edema distance was (1.33±0.34)cm. The tumors appeared as low signal intensity on T1WI and high signal intensity on T2WI, with small patchy short T1 and short T2 signal within lesions. Cystic lesions were observed in 3 lesions, and necrosis and hemorrhage were found in both 7 lesions. Nine lesions demonstrated marked enhancement, with ringlike pattern in 5 lesions, nodular pattern in 3 lesions and patchy pattern in 1 lesion. There was no enhancement in 1 lesion. Hydrocephalus were found in 9 patients. DWI showed restricted diffusion in 8 patients, with mean relative ADC of 1.26±0.12 and minimum relative ADC of 1.12±0.12. In 5 patients who underwent DSC-PWI, markedly high perfusion was demonstrated in 3 patients, moderate perfusion in 1 patient and low perfusion 1 patient demonstrated. The maximum relative cerebral blood volumewas 2.92±0.49. Conclusion: Multimodal MRI manifestations of diffuse midline glioma, H3 K27M mutant are various, but similar to those of high-grade gliomas. Molecular pathology may be considered for deferential diagnosis.