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Child's Nervous System
Published in: Child's Nervous System 1/2017

01-01-2017 | Review Paper

MR imaging of brain pilocytic astrocytoma: beyond the stereotype of benign astrocytoma

Authors: Simona Gaudino, Matia Martucci, Rosellina Russo, Emiliano Visconti, Emma Gangemi, Francesco D’Argento, Tommaso Verdolotti, Libero Lauriola, Cesare Colosimo

Published in: Child's Nervous System | Issue 1/2017

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Abstract

Background

Pilocytic astrocytoma (PA) is the most common pediatric brain glioma and is considered the prototype of benign circumscribed astrocytoma. Despite its low malignancy, the CT and MRI features of brain PA may resemble those of much more aggressive brain tumors. Misdiagnosis of PA is particularly easy when it demonstrates MR morphological and non-morphological findings that are inconsistent with its non-aggressive nature and that overlap with the features of more aggressive brain tumors.

Method

Basing on the evidence that the variation in the histological, genetic, and metabolic “fingerprint” for brain PA is dependent on tumor location, and the hypothesis that tumor location is related to the broad spectrum of morphological and non-morphological MR imaging findings, the authors discuss the MR imaging appearance of brain PA using a location-based approach to underline the typical and less typical imaging features and the main differential diagnosis of brain PA. A brief summary of the main pathological and clinical features, the natural history, and the treatment of brain PA is also provided.

Result

A combination of morphological and non-morphological MR imaging features and a site-based approach to differential diagnosis are required for a pre-operative diagnosis. The new “cutting-edge” MR imaging sequences have the potential to impact the ease and confidence of pediatric brain tumor interpretation and offer a more efficient diagnostic work-up.

Conclusions

Although the typical imaging features of brain pilocytic astrocytoma make radiological diagnosis relatively easy, an atypical and more aggressive appearance can lead to misdiagnosis. Knowing the broad spectrum of imaging characteristics on conventional and advanced MR imaging is important for accurate pre-operative radiological diagnosis and correctly interpreting changes during follow-up.
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Metadata
Title
MR imaging of brain pilocytic astrocytoma: beyond the stereotype of benign astrocytoma
Authors
Simona Gaudino
Matia Martucci
Rosellina Russo
Emiliano Visconti
Emma Gangemi
Francesco D’Argento
Tommaso Verdolotti
Libero Lauriola
Cesare Colosimo
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 1/2017
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-016-3262-4

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