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Computed Tomography and Magnetic Resonance Features of Gliosarcoma: A Study of 54 Cases

Zhang, Bi-Yun MM*; Chen, Hong MD; Geng, Dao-Ying MD*; Yin, Bo MD*; Li, Yu-Xin MD*; Zhong, Ping MD; Wu, Jin-Song MD; Wang, Xiao-Qiang PhD*

Journal of Computer Assisted Tomography: November/December 2011 - Volume 35 - Issue 6 - p 667–673
doi: 10.1097/RCT.0b013e3182331128
Original Article

Objective To investigate the features of pathologically confirmed gliosarcomas using computed tomography (CT) and magnetic resonance (MR) imaging.

Methods We retrospectively reviewed the cross-sectional CT and MR images of 54 patients (37 males and 17 females; mean age, 44.5 years; range, 13–74 years) with gliosarcomas confirmed by histopathology.

Results Across all patients, there were 59 lesions. On nonenhanced CT and MR images, tumors were predominantly inhomogeneous. On the postcontrast CT and MR images, 50 (84.7%) irregular lesions had thick walls with a strong rim- and ringlike enhancement, whereas the remaining 9 (15.3%) round or oval lesions had even thin walls with an enhanced peripheral ring. Magnetic resonance spectroscopy showed increased choline and lactate values, along with decreased N-acetylaspartate and creatine values. On diffusion-weighted imaging, the tumor was slightly or markedly hyperintense compared with the white matter.

Conclusion A well-demarcated mass located peripherally, with rimlike or ring enhancement, is a common presentation of gliosarcoma on CT and MR images. In addition, magnetic resonance spectroscopy and diffusion-weighted imaging can be used to make a differential diagnosis.

From the Departments of *Radiology, †Neuropathology, and ‡Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.

Received for publication June 1, 2011; accepted August 11, 2011.

Reprints: Xiao-Qiang Wang, PhD, or Dao-Ying Geng, MD, Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China (e-mail:,

The authors did not receive any funding for research for this manuscript.

The authors have no conflict of interest.

Bi-Yun Zhang, MM, and Hong Chen, MD, contributed equally to this work.

© 2011 Lippincott Williams & Wilkins, Inc.