Meningiomas with conventional MRI findings resembling intraaxial tumors: Can perfusion-weighted MRI be helpful in differentiation?

Date

2006

Authors

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Journal ISSN

Volume Title

Publisher

Springer

Abstract

Introduction To investigate the contribution of perfusion-weighted MRI to the differentiation of meningiomas with atypical conventional MRI findings from intraaxial tumors. Methods We retrospectively analyzed 54 meningiomas, 12 glioblastomas and 13 solitary metastases. We detected 6 meningiomas with atypical features on conventional MRI resembling intraaxial tumors. The regional cerebral blood flow (rCBV) ratios of all tumors were calculated via perfusion-weighted MRI. The signal intensity-time curves were plotted and three different curve patterns were observed. The type 1 curve resembled normal brain parenchyma or the postenhancement part was minimally below the baseline, the type 2 curve was similar to the type 1 curve but with the postenhancement part above the baseline, and the type 3 curve had the postenhancement part below the baseline accompanied by widening of the curve. Student's t-test was used for statistical analysis. Results On CBV images meningiomas were hypervascular and the mean rCBV ratio was 10.58 +/- 2.00. For glioblastomas and metastatic lesions, the rCBV ratios were 5.02 +/- 1.40 and 4.68 +/- 1.54, respectively. There was a statistically significant difference in rCBV ratios between meningiomas and glioblastomas and metastases (P < 0.001). Only one of the meningiomas displayed a type 2 curve while five showed a type 3 curve. Glioblastomas and metastases displayed either a type 1 or a type 2 curve. None of the meningiomas showed a type 1 curve and none of the glioblastomas or metastases showed a type 3 curve. Conclusion Differentiating meningiomas with atypical conventional MRI findings from malignant intraaxial tumors can be difficult. Calculation of rCBV ratios and construction of signal intensity-time curves may contribute to the differentiation of meningiomas from intraaxial tumors.

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Keywords

Neurosciences & neurology, Radiology, nuclear medicine & medical imaging, Perfusion imaging, Meningioma, Magnetic resonance, Brain tumors, Maps, Gliomas, Brain, Contrast, Gradient-echo, Cystic meningiomas, Malignant meningiomas, Cerebral blood-volume

Citation

Hakyemez, B. vd. (2006). ''Meningiomas with conventional MRI findings resembling intraaxial tumors: can perfusion-weighted MRI be helpful in differentiation?''. Neuroradiology, 48(10), 695-702.