Glioblastoma (WHO grade 4 astrocytoma), recurrent

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Clinical History: 
A 55 year old man, with a previous partial tumor resection

Diagnosis:
Glioblastoma (WHO grade 4 astrocytoma), recurrent

MR Technique: 
Scans were acquired on a Siemens 1.5 T wide (open) bore system (Espree). Image acquisition times were 3:54 and 3:44 respectively (min:sec), with each scan 2D in type (the FLAIR being FSE, and the T1 SE), with a slice thickness of 5 mm. Sequence parameters were TR/TE/TI = 9000/136/2500 (using a 150° flip angle) and TR/TE = 500/12, with pixel (in plane) dimensions of 1×1 mm2 for both scans. A macrocyclic gadolinium chelate was administered intravenously for contrast enhancement, at standard dose, 0.1 mmol/kg.

Imaging Findings:
Extensive vasogenic edema is noted in the left cerebral hemisphere, best seen on FLAIR with abnormal high signal intensity. The atrium of the left lateral ventricle, together with the sulci of the left hemisphere, are obliterated due to mass effect. A large mass lesion is noted, with an irregular thick rim of enhancement peripherally, and a large central non-enhancing region, consistent with fluid/necrosis.