Morphological spectrum of intracranial meningiomas on computed tomography (CT) and magnetic resonance imaging (MRI)

Authors : Rishi Philip Mathew, Kumar Muthukumar, Praveen Kumar Natesan, Muthukalathi Karunakaran

DOI : 10.18231/2348-7682.2018.0017

Volume : 8

Issue : 2

Year : 0

Page No : 70-78

Meningiomas are the most common extra axial and non-glial primary neoplasms of the central nervous system. They account for nearly 15% of all intracranial neoplasms. The present study was planned to identify and describe the morphological and imaging characteristics of both typical and atypical meningiomas on CT and MRI, including Diffusion Weighted Imaging (DWI) and MR Spectroscopy (MRS). CT and MRI images of 43 patients histologically proven to have meningioma were retrospectively evaluated. The images were evaluated for- tumor location, imaging characteristics, atypical patterns of presentation and as well as advanced imaging features. Statistical analysis used included percentage and frequency. Institutional ethical committee clearance was obtained prior to commencement of the study. Our study population comprised of 23 females and 20 males. The bulk of our population belonged to 5^th decade group (44%). The most common tumor site was the frontal lobe (40%). Features seen on imaging included- well defined margins (100%), broad dural base (67%), calcification-84% (n=36/43) and peritumoral edema (51%). On MRI, 84% and 67% of the lesions were T1 isointense and T2 mildly hyperintense respectively, when compared to the brain parenchyma, diffusion restriction was variable (benign meningiomas- 46% and atypical meningiomas-100%). Choline (100%) and Alanine peaks (28%) were observed on MRS. On post contrast imaging, homogeneous enhancement was seen in 95%, while a dural tail was seen in only 51% of the cases. Benign meningiomas present with typical extra-axial features (broad dural base, white matter buckling, CSF cleft, dural tail etc.), while atypical meningiomas have varied presentations which include-cystic/necrotic areas, significant vasogenic edema with mass effect and diffusion restriction on DWI.

Keywords: Meningioma, Extra-axial lesion, Dural tail.

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