Abstract
Advanced magnetic resonance imaging (MRI) techniques, such as diffusion tensor imaging (DTI), dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion, and proton magnetic resonance spectroscopy (MRS) have proven to be useful in predicting tumour grade and outcome in glial brain tumours. 1 Law M. Yang S. Wang H. et al. Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. AJNR Am J Neuroradiol. 2003; 24: 1989-1998 PubMed Google Scholar , 2 Provenzale J.M. Mukundan S. Barboriak D.P. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response. Radiology. 2006; 239: 632-649 Crossref PubMed Scopus (307) Google Scholar , 3 Stadlbauer A. Gruber S. Nimsky C. et al. Preoperative grading of gliomas by using metabolite quantification with high-spatial-resolution proton MR spectroscopic imaging. Radiology. 2006; 238: 958-969 Crossref PubMed Scopus (159) Google Scholar , 4 Weber M.A. Zoubaa S. Schlieter M. et al. Diagnostic performance of spectroscopic and perfusion MRI for distinction of brain tumors. Neurology. 2006; 66: 1899-1906 Crossref PubMed Scopus (182) Google Scholar , 5 Young R.J. Knopp E.A. Brain MRI: tumor evaluation. J Magn Reson Imag. 2006; 24: 709-724 Crossref PubMed Scopus (59) Google Scholar However, discrepancies do occur when advanced techniques suggest a biologically more malignant behaviour in low-grade lesions such as gangliogliomas. 6 Kincaid P.K. El-Saden S.M. Park S.H. et al. Cerebral gangliogliomas: preoperative grading using FDG-PET and Tl-201-SPECT. AJNR Am J Neuroradiol. 1998; 19: 801-806 PubMed Google Scholar , 7 Koeller K.K. Henry J.M. Superficial gliomas: radiologic–pathologic correlation. RadioGraphics. 2001; 21: 1533-1556 Crossref PubMed Scopus (111) Google Scholar , 8 Kumabe T. Shimizu H. Sonoda Y. et al. Thallium-201 single-photon emission computed tomographic and proton magnetic resonance spectroscopic characteristics of intracranial ganglioglioma: three technical case reports. Neurosurgery. 1999; 45: 183-187 Crossref PubMed Scopus (27) Google Scholar , 9 Provenzale J.M. Arata M.A. Turkington T.G. et al. Gangliogliomas: characterization by registered positron emission tomography MR images. AJR Am J Roentgenol. 1999; 172: 1103-1107 Crossref PubMed Scopus (22) Google Scholar , 10 Wang Z.Y. Sutton L.N. Cnaan A. et al. Proton MR spectroscopy of pediatric cerebellar tumors. AJNR Am J Neuroradiol. 1995; 16: 1821-1833 PubMed Google Scholar Recently, we had the opportunity to diagnose and follow a child with infiltrative cerebellar ganglioglioma. The purpose of this paper is to contribute to the existing body of knowledge about this rare entity by reporting and discussing the results of conventional and advanced MRI, including DTI, DSC, MRS, susceptibility-weighted imaging (SWI) and 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) with respect to the histopathological features of the tumour, and reviewing currently available literature.
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