, Volume 61, Issue 2, pp 225–227 | Cite as

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

  • Derek R. JohnsonEmail author
  • Timothy J. Kaufmann
  • Sohil H. Patel
  • Andrew S. Chi
  • Matija Snuderl
  • Rajan Jain
Short Report


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.


Glioma MRI IDH-mutation FLAIR Mismatch 


Compliance with ethical standards


This study was funded in part by a RSNA Research Scholar Grant (RSCH1819) (to SHP).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Department of Radiology and Medical ImagingUniversity of Virginia Health SystemCharlottesvilleUSA
  3. 3.Perlmutter Cancer CenterNew York University School of MedicineNew YorkUSA
  4. 4.Department of PathologyNew York University School of MedicineNew YorkUSA
  5. 5.Department of RadiologyNew York University School of MedicineNew YorkUSA
  6. 6.Department of NeurosurgeryNew York University School of MedicineNew YorkUSA

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