Fig. 14
From: New MR sequences in daily practice: susceptibility weighted imaging. A pictorial essay
Characterisation and grading of a glial tumour. A 30-year-old man with dizziness, long-standing behavioural changes and subsequent diagnosis of intra-axial cerebral tumour. a T2-weighted image shows a large frontal infiltrating glioma. b SWI, unprocessed image: absence of intratumoural susceptibility signals (due either to calcifications, haemorrhages or venous vasculature). c Contrast-enhanced SWI: detailed visualisation of the margins of a large anaplastic area (asterisk), which is in good correlation with enhancement characteristics (d), hypervolaemia on PWI relative cerebral blood volume (rCBV) map (e) and MR spectroscopy (f). d Post-contrast T1-weighted image. e PWI, rCBV map: area of increased cerebral blood volume (open arrow). f Single-voxel MR spectroscopy, showing inversion of the Cho/NAA ratio and the presence of a lactate peak. Targeted stereotactic biopsy in the supposed necrotic area confirmed the hypothesis of gliomatosis cerebri WHO grade III with several necrotic foci