Meningioma MRI

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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.[1]

MRI

Head MRI may be helpful in the diagnosis of meningioma. Findings on MRI suggestive of/diagnostic of meningioma include:[2]

  • Lobular, extra axial masses with well-circumscribed margins
  • Broad-based dural attachment
  • Inward displacement of the cortical grey matter
  • Meningioma en plaque: Tumor with a more infilterating growth pattern over the dura
  • Ardent, homogeneous enhancement after contrast administration
  • In some cases, may have areas of central necrosis or calcification that do not enhance
  • Peritumoral edema
  • Dural tail: ehancement of the dura infiltrating away from the lesion
  • A csf cleft (may contain csf or cortical vessels) between the tumor and the underlying brain cortex


  • On T1-weighted sequence:
  • Isointensity to slight hypointensity relative to grey matter
  • Extensive dural thickening in meningioma en plaque
  • Uniform low signal intensity in microcystic meningiomas


  • On T2-weighted sequence:
  • Isointensity to slight hyperintensity relative to grey matter
  • Calcification showing as areas of low signal intensity
  • High signal intensity in microcystic meningiomas

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References

  1. Meningioma. Radiopaedia(2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015
  2. Watts J, Box G, Galvin A, Brotchie P, Trost N, Sutherland T (2014). "Magnetic resonance imaging of meningiomas: a pictorial review". Insights Imaging. 5 (1): 113–22. doi:10.1007/s13244-013-0302-4. PMC 3948902. PMID 24399610.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Image courtesy of Dr Sajoscha Sorrentino Radiopaedia(original file "here"). Creative Commons BY-SA-NC
  4. Image courtesy of Dr Frank Gaillard Radiopaedia(original file "here"). Creative Commons BY-SA-NC


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