Publications

Authors:

Zoccarato, Marco; Valeggia, Silvia; Zuliani, Luigi; Gastaldi, Matteo; Mariotto, Sara; Franciotta, Diego; Ferrari, Sergio; Lombardi, Giuseppe; Zagonel, Vittorina; De Gaspari, Piera; Ermani, Mario; Signori, Alessio; Pichiecchio, Anna; Giometto, Bruno; Manara, Renzo

Title:

Conventional brain MRI features distinguishing limbic encephalitis from mesial temporal glioma

Year:

2019

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Format:

A Stampa

Referee:

Sì

Name of journal:

JOURNAL OF NEURORADIOLOGY

ISSN of journal:

0028-3940

N° Volume:

61

Number or Folder:

8

Page numbers:

853-860

Keyword:

AK5 antibodies; Brain MRI; Glioma; Limbic encephalitis; Neuronal antibodies

Short description of contents:

Purpose: Radiological hallmark of autoimmune limbic encephalitis (LE) is a hyperintense signal in MRI T2-weighted images of mesial temporal structures. We aimed to identify conventional magnetic resonance imaging (MRI) features that can help distinguish LE from temporal glioma.MethodsBrain MRIs of 25 patients affected by antibody-positive autoimmune LE, 24 patients affected by temporal glioma (tumor group), and 5 negative controls were retrospectively blindly evaluated in random order.ResultsTen brain MRIs from the LE group were correctly recognized; one additional patient with mesial temporal hyperintensity with anti-AK5 abs LE was wrongly diagnosed as having a tumor. The brain MRIs of the remaining 14 of the 25 patients with LE were judged negative or, in three cases, showed features not typical for LE. In the tumor group, all MRIs showed pathological alterations diagnosed as tumors in 22/24 cases and as LE in two (2/22, 9%). Unilateral lesions were more common in tumors than in neuroradiologically abnormal LE (96% vs. 18%, p<0.001). T2/FLAIR hyperintensity of the parahippocampal gyrus was associated more with tumor than with LE (71% vs. 18%) (p=0,009), as T2/FLAIR hyperintensity of extralimbic structures (p=0.015), edema (p=0.041), and mass effect (p=0.015). Maintenance of gray/white matter distinction was strongly associated with LE (91% vs. 17%, p<0.001).ConclusionConventional brain MRI is a fundamental tool in the differential diagnosis between LE and glioma. Bilateral involvement and maintenance of gray/white matter distinction at the cortical/subcortical interface are highly suggestive of LE.

Web page:

https://doi.org/10.1007/s00234-019-02212-1

Product ID:

118018

Handle IRIS:

11562/1031103

Last Modified:

November 15, 2022

Bibliographic citation:

Zoccarato, Marco; Valeggia, Silvia; Zuliani, Luigi; Gastaldi, Matteo; Mariotto, Sara; Franciotta, Diego; Ferrari, Sergio; Lombardi, Giuseppe; Zagonel, Vittorina; De Gaspari, Piera; Ermani, Mario; Signori, Alessio; Pichiecchio, Anna; Giometto, Bruno; Manara, Renzo, Conventional brain MRI features distinguishing limbic encephalitis from mesial temporal glioma «JOURNAL OF NEURORADIOLOGY» , vol. 61 , n. 8 , 2019 , pp. 853-860

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