The prognosis for low-grade gliomas is significantly better than that of high-grade gliomas, which in layman’s terms means that patients with low-grade gliomas live much longer than patients with high-grade gliomas. So when MRI suspects a glioma in the brain, it is clear that patients with low-grade gliomas are more fortunate than those with high-grade gliomas. However, whether a glioma is low-grade or high-grade is not something that can be determined based on MRI. A low-grade glioma diagnosed by pre-surgical MRI may well end up being a high-grade glioma even though the tumor is not significantly enhanced on MRI and has many features consistent with a low-grade glioma. In this case of Ms. Lai, the tumor was located in the right temporal lobe, and the pathological diagnosis after surgery was: mesenchymal astrocytoma, WHO grade III, IDH wild type. Regardless of the extent of surgical resection, further radiotherapy is needed after surgery to further kill the remaining tumor cells and delay the recurrence of glioma to maximize the patient’s survival time. It is not uncommon to see inconsistencies between the diagnostic imaging results and the final pathological diagnosis or final diagnosis in clinical work, and clinicians are not surprised. After all, the imaging diagnosis is not the final diagnosis, but only a reference for the clinician’s final diagnosis. The pathological diagnosis is also the most important reference for the clinician to make the final diagnosis, and is generally the most accurate standard, but the final diagnosis still requires the clinician to combine the pathological and other results to make a comprehensive judgment.