There is an exception to every rule-T2-FLAIR mismatch sign in gliomas

Derek R Johnson; Timothy J Kaufmann; Sohil H Patel; Andrew S Chi; Matija Snuderl; Rajan Jain

doi:10.1007/s00234-018-2148-4

There is an exception to every rule-T2-FLAIR mismatch sign in gliomas

Neuroradiology. 2019 Feb;61(2):225-227. doi: 10.1007/s00234-018-2148-4. Epub 2018 Dec 18.

Authors

Derek R Johnson¹, Timothy J Kaufmann², Sohil H Patel³, Andrew S Chi⁴, Matija Snuderl⁵, Rajan Jain^{6

7}

Affiliations

¹ Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Johnson.derek1@mayo.edu.
² Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
³ Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA.
⁴ Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA.
⁵ Department of Pathology, New York University School of Medicine, New York, NY, USA.
⁶ Department of Radiology, New York University School of Medicine, New York, NY, USA.
⁷ Department of Neurosurgery, New York University School of Medicine, New York, NY, USA.

PMID: 30565056
DOI: 10.1007/s00234-018-2148-4

Abstract

The T2-FLAIR mismatch sign, in which a low-grade glioma is hyperintense on T2-weighted MR and centrally hypointense on T2-weighted FLAIR MR, has been reported as 100% specific for IDH-mutant astrocytomas in several series. We report several cases of "false positive" T2-FLAIR mismatch sign occurring outside the context of IDH-mutant astrocytomas, predominantly in children or young adults with pediatric-type gliomas. These results suggest caution in the interpretation of the T2-FLAIR mismatch sign in the pediatric glioma population.

Keywords: FLAIR; Glioma; IDH-mutation; MRI; Mismatch.

Publication types

Case Reports

MeSH terms

Adolescent
Adult
Brain Neoplasms / diagnostic imaging*
Brain Neoplasms / pathology
Child
False Positive Reactions
Glioma / diagnostic imaging*
Glioma / pathology
Humans
Infant
Magnetic Resonance Imaging / methods*
Male
Retrospective Studies