Meningioma MRI: Difference between revisions

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Revision as of 00:25, 27 September 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

Brain MRI with gadolinium is the investigation of choice for the diagnosis of meningioma. On brain MRI, meningioma is characterized by a homogeneous, well circumscribed, and extra-axial mass with a broad dural base. Other Findings on brain MRI suggestive of meningioma include CSF vascular cleft sign, dural tail sign, and sunburst or spokewheel appearance of the vessels.

MRI

Brain MRI with gadolinium is the investigation of choice for the diagnosis of meningioma.
On braim MRI, meningioma is characterized by a homogeneous, well circumscribed, and extra-axial mass with a broad dural base.
Other Findings on brain MRI suggestive of meningioma include:

Dural tail sign
CSF vascular cleft sign
Sunburst or spokewheel appearance of the vessels

When the appearance and location of meningioma are typical, the diagnosis can be made with a very high degree of specificity.
In the case of anaplastic meningioma, the degree of edema correlates with the invasion of the surrounding tissue by the tumor.
Signal characteristics include:

T1 weighted image illustrates:

Isointense mass in 60-90% of the cases
Hypointense mass in 10-40% of cases

T1 C+ weighted image (image enhanced with gadolinium) usually illustrates an intense and homogeneous enhancement
T2 weighted image illustrates:

Isointense mass in 50% of the cases
Hyperintense mass in 35-40% of the cases
Hypointense mass in 10-15% of the cases

References

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 {{Meningioma}}
-{{CMG}}
+{{CMG}} {{AE}}{{HL}}
 ==Overview==
-Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture. It is a very valuable test for meningioma.
+Brain MRI with gadolinium is the investigation of choice for the diagnosis of meningioma. On brain MRI, meningioma is characterized by a homogeneous, well circumscribed, and extra-axial mass with a broad dural base. Other Findings on brain MRI suggestive of meningioma include CSF vascular cleft sign, dural tail sign, and sunburst or spokewheel appearance of the vessels.
 ==MRI==
-Meningiomas are readily visualized on [[MRI]] with gadolinium attributed to the fact that meningiomas are extra axial and vascularized.
+* Brain MRI with gadolinium is the investigation of choice for the diagnosis of meningioma.
+* On braim MRI, meningioma is characterized by a homogeneous, well circumscribed, and extra-axial mass with a broad dural base.
-MRI
+* Other Findings on brain MRI suggestive of meningioma include:
+:* Dural tail sign
-As is the case with most other intracranial pathology, MRI is the investigation of choice for the diagnosis and characterisation of meningiomas. When appearance and location is typical, the diagnosis can be made with a very high degree of certainty. In many instances however the appearances are atypical.
+:* CSF vascular cleft sign
+:* Sunburst or spokewheel appearance of the vessels
-Meningiomas typically appear as extra-axial masses with a broad dural base. They are usually homogeneous and well circumscribed, although many variants are encountered.
+*When the appearance and location of meningioma are typical, the diagnosis can be made with a very high degree of specificity.
+*In the case of anaplastic meningioma, the degree of edema correlates with the invasion of the surrounding tissue by the tumor.
-Signal characteristics include:
+*Signal characteristics include:
+:*T1 weighted image illustrates:
-    T1
+::*Isointense mass in 60-90% of the cases
-        isointense: ~60-90% 3,8, 13
+::*Hypointense mass in 10-40% of cases
-        somewhat hypointense: 10-40% compared to grey matter
+:*T1 C+ weighted image (image enhanced with gadolinium) usually illustrates an intense and homogeneous enhancement
-    T1 C+ (Gd): usually intense and homogeneous enhancement
+:*T2 weighted image illustrates:
-    T2
+::*Isointense mass in 50% of the cases
-        isointense: ~50% 3,8,13
+::*Hyperintense mass in 35-40% of the cases
-        hyperintense: 35-40%
+::*Hypointense mass in 10-15% of the cases
-            usually correlates with soft textures and hypervascular tumours 13
-            very hyperintense lesions may represent the microcystic variant 12
-        hypointense: 10-15% compared to grey matter and usually correlates with harder texture and more fibrous and calcified contents
-    DWI: atypical and malignant subtypes may show greater than expected restricted diffusion although recent work suggests that this is not useful in prospectively predicting histological grade 15-16
-    MR spectroscopy: Usually it does not play a significant role in diagnosis but can help distinguish meningiomas from mimics. Features include:
-        increase in alanine (1.3-1.5 ppm)
-        increased glutamine/glutamate
-        increased choline (Cho): cellular tumour
-        absent or significantly reduced N-acetylaspartate (NAA): non-neuronal origin
-        absent or significantly reduced creatine (Cr)
-    MR perfusion: it has good correlation between volume transfer constant (k-trans) and histological grade
-Helpful signs include
-    CSF vascular cleft sign, which is not specific for meningioma, but helps establish the mass to be extra-axial; loss of this can be seen in grade II and grade III which may suggest brain parenchyma invasion
-    dural tail seen in 60-72% 2 (note that a dural tail is also seen in other processes)
-    sunburst or spokewheel appearance of the vessels
-Meningiomas typically narrow arteries which they encase. This is a useful sign to distinguish a meningioma from a pituitary macroadenoma which will not.
-Oedema can be seen and correlates with size, rapid growth, location (convexity and parasagittal > elsewhere), and invasion in the case of malignant meningiomas.
 ==References==

Meningioma MRI: Difference between revisions

Revision as of 00:25, 27 September 2015

Overview

MRI

References

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