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.


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