Computed tomography and magnetic resonance imaging findings in patients with oligodendrogliomas: clinical and pathological correlation

Radiologia Brasileira 06/2001; 34(3):145-149. DOI: 10.1590/S0100-39842001000300006


Oligodendrogliomas são neoplasias do tecido neuroepitelial glial originárias de oligodendrócitos. São tumores infreqüentes, responsáveis por cerca de 4% a 7% das neoplasias primárias do cérebro, predominantemente supratentoriais. O presente trabalho consistiu na avaliação dos achados de imagem pré-operatória em tomografia computadorizada e ressonância magnética e correlação clínica e patológica, levando-se em consideração a presença de tumores puros ou mistos, com componente astrocitário e o seu grau de anaplasia. O aspecto mais freqüente foi o de lesão hipodensa na tomografia computadorizada ou com hipossinal em T1 e hipersinal em T2 na ressonância magnética, podendo ter componente cístico, com pouco edema ao redor, apresentando calcificações, quase sempre grosseiras, em dois terços dos casos. Reforço após contraste ocorre em 80% dos casos, na maioria discreto.

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Available from: Simão Marcelo Novelino, Oct 02, 2015
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    ABSTRACT: To review the clinical and imaging findings in pediatric and adolescent intracranial pure oligodendrogliomas. The clinical, CT, and MR data in 39 surgically proved pure oligodendrogliomas were retrospectively reviewed. The frontal or temporal lobes were involved in 32 (82%) cases. Seventy percent of the tumors were hypodense on CT, three-fourths were hypointense on T1-weighted images, and all were hyperintense on spin-density and T2-weighted images. Fewer than 40% of the lesions demonstrated calcification, and nearly 60% had well-defined margins. Mass effect was seen in fewer than half of the cases, and edema could be separately identified in only one case. Tumor enhancement was seen in fewer than 25%. In 39 cases after partial (3), subtotal (16), or total (20) resection, follow-up studies demonstrated stability over a mean period of 5 years. The findings in this pediatric series of pure oligodendrogliomas (without mixed cell elements) differ from previous adult series in that calcification, contrast enhancement, and edema are seen less frequently. In addition, very slow or no growth is often characteristic, and these patients have an excellent prognosis with surgical resection.
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    ABSTRACT: To determine the prognostic significance of histologic variables in oligodendroglial neoplasms, the presence and degree of 15 such variables were correlated with postoperative survival rates in 71 patients. By univariate analysis, prognostically significant factors, in order of decreasing importance, were mitoses (log), necrosis, nuclear cytologic atypia, vascular hypertrophy, and vascular proliferation. When studied by stepwise regression, necrosis and the number of mitoses contained all of the prognostically useful information. When each of the five variables significant by univariate analysis was tested in the Cox model by adding a variable to the model containing the other four, necrosis was found to be the only independently significant variable. There were significant positive pairwise correlations between each of the five significant histologic variables except for cytologic atypia with necrosis. The only histologic variable with a significant association with older age was the number of mitoses. These results suggest that necrosis and, to a lesser extent, the mitotic count are features that, in the appropriate setting, can be used to identify the "anaplastic" oligodendroglioma.
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    ABSTRACT: To define optimum treatment and delineate recurrence patterns and prognostic factors in oligodendrogliomas, the authors reviewed the records of 49 patients who received treatment for these rare tumors between 1957 and 1990; 41 patients had at least 5 years follow-up. Age, race, gender, performance of computed tomography (CT), tumor location and grade, histologic findings, calcifications, surgery with or without postoperative radiation therapy, and the doses and fields used in radiation therapy were evaluate for prognostic relevance by means of chi 2 and Wilcoxon log-rank tests. Metaanalysis of relevant literature was also performed. Actuarial survival at 5, 10, and 15 years was 61%, 41%, and 24%, respectively. The pattern of recurrence was predominantly local alone (30 of 31 patients [97%] with recurrence). Age younger than 40 years, low-grade tumor, calcifications, and performance of CT were statistically significant prognostic factors. A trend existed toward improved 5-year survival in patients who underwent postoperative radiation therapy (P = .067); at stratification for subtotal resection, this improvement became significant (74% vs 25%, P = .019). Metaanalysis demonstrated a survival advantage for surgery with radiation therapy versus surgery only (56% vs 42%, P < .01).
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