Fig 2 1 A Axial Flair MRI Fig

Fig 2. 1 A: Axial Flair MRI Fig 2. 1 B: Axial T 1 Weighted (Wtd. ) MRI Fig 2. 1 C: Post-Contrast Axial T 1 Wtd. MRI 56 Year-old male with 3 month history of gradual weakness of the right upper extremity. Diagnosis: ? ? ? Fig 2. 1 D: Post Contrast Coronal T 1 Wtd. MRI Fig 2. 1 E: Post Contrast Sagital T 1 Wtd. MRI

Fig 2. 2 A: Axial Flair MRI Fig 2. 2 B: Axial T 1 Wtd. MRI Fig 2. 2 C: Post-Contrast Axial T 1 Wtd. MRI 51 Year-old male with history of seizures and was involved in a car accident, leading to imaging studies. Diagnosis: ? ? ? Fig 2. 2 D: Post Contrast Coronal T 1 Wtd. MRI

Fig 2. 3 A: Axial Flair MRI Fig 2. 3 B: Axial T 1 Wtd. MRI Fig 2. 3 C: Post-Contrast Axial T 1 Wtd. MRI 19 Year-old young lady with seizures and headache Diagnosis: ? ? ? Fig 2. 3 D: Post Contrast Sagital T 1 Wtd. MRI

Fig 2. 4 A: Axial T 2 Wtd. MRI Fig 2. 4 B: Axial T 1 Wtd. MRI Fig 2. 4 C: Post-Contrast Axial T 1 Wtd. MRI 12 Year-old boy with headache, nausea and vomiting for three months. Diagnosis: ? ? ? Fig 2. 4 D: Post Contrast Coronal T 1 Wtd. MRI

Fig 2. 5 A: Axial Flair MRI Fig 2. 5 B: Axial T 1 Wtd. MRI Fig 2. 5 C: Post-Contrast Axial T 1 Wtd. MRI 60 Year-old male with six month history of gradual memory loss, disorientation and headache. Diagnosis: ? ? ? Fig 2. 5 D: Post Contrast Coronal T 1 Wtd. MRI

Match the following Gliomas shown in figs 2. 1 thru 2. 5 to WHO (World Health Organization) Classification: Fig. 2. 1 A. Butterfuly Glioblastoma Fig. 2. 2 B. Grade 2 Astrocytoma Fig. 2. 3 C. Pilocytic Astrocytoma (Grade 1 Astrocytoma) Fig. 2. 4 D. Glioblastoma (Grade 4 Astrocytoma) Fig. 2. 5 E. Anaplastic Astrocytoma Grade 3 See Next Panel for Correct Answers

Match the following Gliomas shown in figs 2. 1 thru 2. 5 to WHO (World Health Organization) Classification: Correct Answers Fig. 2. 1 Fig. 2. 2 Fig. 2. 3 D. Glioblastoma (Grade 4 Astrocytoma) E. Anaplastic Astrocytoma Grade 3 B. Grade 2 Astrocytoma C. Pilocytic Astrocytoma (Grade 1 Astrocytoma) Fig. 2. 4 Fig. 2. 5 A. Butterfuly Glioblastoma

E Fig 2. 1 A: Axial Flair MRI Fig 2. 1 B: Axial T 1 Weighted (Wtd. ) MRI Fig 2. 1 C: Post-Contrast Axial T 1 Wtd. MRI An irregular enhancing ring lesion (arrow) is seen involving the left parietal lobe. Tumor is associated with edema (E) best noticed on FLAIR image (A). DIAGNOSIS: GLIOBLASTOMA • Grade IV Astrocytoma (WHO Classification) • Older Patient • Imaging Features: Tumor with irregular peripheral enhancement with central necrosis. • Median survival is 1 – 2 years following Surgery/Radiation therapy/Chemotherapy.

Fig 2. 2 A: Axial Flair MRI Fig 2. 2 B: Axial T 1 Wtd. MRI Fig 2. 2 C: Post-Contrast Axial T 1 Wtd. MRI Fig 2. 2 D: Post Contrast Coronal T 1 Wtd. MRI An ill-defined non-enhancing tumor (yellow arrows) is seen in the left parietal lobe with spotty areas of enhancement (red arrows). DIAGNOSIS: Anaplastic Astrocytoma • Grade III Astrocytoma (WHO Classification) • Usually seen between 40 – 60 years of age • Imaging Features: Ill-defined non-enhancing tumor without feeble enhancement. • Median survival is 5 – 6 years following Surgery/Radiation therapy/Chemotherapy.

Fig 2. 3 A: Axial Flair MRI Fig 2. 3 B: Axial T 1 Wtd. MRI Non-enhancing tumor (arrow) involving the right temporal lobe. DIAGNOSIS: GRADE III ASTROCYTOMA (LOW GRADE) • Children and young adults • Imaging Features: Non-enhancing tumors. Calcification can be seen. • Total cure from surgery to median survival of 7 - 10 years. Fig 2. 3 C: Post-Contrast Axial T 1 Wtd. MRI

Fig 2. 4 A: Axial T 2 Wtd. MRI Fig 2. 4 B: Axial T 1 Wtd. MRI Fig 2. 4 C: Post-Contrast Axial T 1 Wtd. MRI A large cystic tumor (yellow arrow) with a mural enhancing nodule (red arrow) is seen within the left cerebellar hemisphere. DIAGNOSIS: PILOCYTIC ASTROCYTOMA • Grade I Astrocytoma (WHO Classification) • Children and young adults • Imaging Features: cyst within enhancing tumor nodule. • Surgical resection can result in complete cure.