Objective To investigate the magnetic resonance imaging(MRI)multimodality features of pleomorphic xanthoastrocytoma(PXA).Methods The clinical data of 35 patients with PXA confirmed by pathology in multiple centers from February 2018 to February 2023 were analyzed retrospectively,and their MRI multimodality findings were summarized.Results Among 35 patients,33(94.3%)developed supratentorial,2(5.7%)developed infratentorial,34(97.1%)had single lesions,and1(2.9%)had multiple lesions.Cystic type was found in4 cases(11.4%),cystic nodular type in9(25.7%),cystic solid type in 8(22.9%),and solid type in 14(40%).MRI mostly showed regular or irregular masses with clear or unclear borders,homogeneous or heterogeneous significant enhancement on contrast-enhanced scans,and meningeal enhancement in 10 cases.Diffusion weighted imaging(DWI)showed isointensity or slightly hyperintensity with a mean apparent diffusion coefficient(ADC)value of(0.79±0.39)×10-3 mm2/s.Perfusion weighted imaging(PWI)showed isointensity/slightly hyperperfusion.Magnetic resonance spectroscopy(MRS)showed decreased NAA peak and increased Cho peak,and susceptibility weighted imaging(SWI)showed that the tumor could be associated with hemorrhage and calcification.7 patients had no peritumoral edema,8 had mild edema,9 had moderate edema,and 11 had severe edema.There were statistically significant differences in age and tumor classification between the grade Ⅱ group and the grade Ⅲ group(P<0.05).There were no statistically significant differences in gender,maximum diameter of the tumor,shape,border,peritumoral edema,meningeal enhancement,degree of enhancement and enhancement pattern(P>0.05).Conclusions PXA is rare,and its MRI findings are complex,and recognizing its MRI multimodality findings is conducive to its diagnosis and differential diagnosis.
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