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{{Meningioma}}
{{Meningioma}}
{{CMG}} {{AE}}{{HL}}
{{CMG}} {{AE}} {{IO}} {{HL}}


==Overview==
==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 [[vessel]]s.<ref name="raio">Meningioma. Radiopaedia(2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref>
[[MRI]] with [[gadolinium]] is the investigation of choice for the diagnosis of meningioma. On MRI, meningioma is characterized by a [[homogeneous]], well circumscribed, and extra-axial mass with a broad [[Dura mater|dural]] base. Other findings on [[Magnetic resonance imaging|MRI]] suggestive of meningioma include [[CSF]] [[vascular]] [[cleft]] sign, [[Dura mater|dural]] tail sign, and central [[necrosis]] or [[calcification]] that do not enhance. Meningiomas may appear different on T1 and T2-weighted sequence but with a few similarities.


==MRI==
==MRI==
* Brain [[MRI]] with [[gadolinium]] is the investigation of choice for the diagnosis of meningioma.<ref name="raio">Meningioma. Radiopaedia(2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref>
* 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:
:* 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]] observed on MRI correlates with the invasion of the surrounding tissue by the [[tumor]].
*MRI image characteristics observed among meningioma patients include:
:*'''T1 weighted image''' demonstrates:
::*Isointense mass in 60-90% of the cases
::*Hypointense mass in 10-40% of cases
:*'''T1 weighted image with gadolinium contrast''' demonstrates:
::*Intense and homogeneous enhancement
:*'''T2 weighted image''' demonstrates:
::*Isointense mass in 50% of the cases
::*Hyperintense mass in 35-40% of the cases
::*Hypointense mass in 10-15% of the cases


==Gallery==
Head [[Magnetic resonance imaging|MRI]] may be helpful in the diagnosis of meningioma. Findings on [[Magnetic resonance imaging|MRI]] suggestive of/diagnostic of meningioma include:<ref name="pmid24399610">{{cite journal| author=Watts J, Box G, Galvin A, Brotchie P, Trost N, Sutherland T| title=Magnetic resonance imaging of meningiomas: a pictorial review. | journal=Insights Imaging | year= 2014 | volume= 5 | issue= 1 | pages= 113-22 | pmid=24399610 | doi=10.1007/s13244-013-0302-4 | pmc=3948902 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24399610  }} </ref>
<gallery>
*Lobular, extra axial masses with well-circumscribed margins
Image:
*Broad-based [[Dura mater|dural]] attachment
MRI convexity meningioma.jpg|Convexity meningioma<ref name="r">Image courtesy of Dr Sajoscha Sorrentino [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/convexity-meningioma-1 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> 
*Inward displacement of the cortical [[grey matter]]
*Meningioma en plaque: [[Tumor]] with a more infiltrating growth pattern over the [[Dura mater|dura]]
*Ardent, [[homogeneous]] enhancement after [[contrast]] administration
*In some cases, may have areas of central [[necrosis]] or [[calcification]] that do not enhance
*Peritumoral [[edema]]
*[[Dura mater|Dural]] tail: enhancement of the [[Dura mater|dura]] infiltrating away from the [[lesion]]
*A [[CSF]] [[cleft]] (may contain [[CSF]] or [[Cortical area|cortical]] [[Blood vessel|vessels]]) between the [[tumor]] and the underlying [[brain]] [[cortex]]
*Intratumoral and peritumoral [[Cyst|cysts]] in cystic meningiomas


Image:
*On T1-weighted sequence:
MRI Atypical meningioma.jpg|Atypical meningioma<ref name="r">Image courtesy of  Dr Sajoscha Sorrentino [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/convexity-meningioma-1 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
:* Isointensity to slight hypointensity relative to [[grey matter]]
:* Extensive [[Dura mater|dural]] thickening in meningioma en plaque
:* Uniform low signal intensity in microcystic meningiomas


Image:
*On T2-weighted sequence:
MRI meningioma anaplastic Dr Frank Gaillard.jpg|Anaplastic meningioma<ref>Image courtesy of  Dr Frank Gaillard [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/images/22491 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
:* Isointensity to slight hyperintensity relative to [[grey matter]]
:* [[Calcification]] showing as areas of low signal intensity
:* High signal intensity in microcystic meningiomas


Image:
==Gallery==
MRI malignant meningioma Dr Ahmed Abd Rabou.jpg|Malignant meningioma<ref name="r">Image courtesy of  Dr Ahmed Abd Rabou [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/malignant-meningioma-1 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
[[File:Cerebellopontine-angle-meningioma-5.jpg|400px|thumb|left|MRI showing meningioma in the cerebellopontine angle [https://radiopaedia.org/articles/meningioma?lang=us source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. ]]]
 
<br style="clear:left" /> [[File:Cystic meningioma.jpg|400px|thumb|left|MRI showing cystic meningioma [https://radiopaedia.org/articles/meningioma?lang=us source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. ]]]
Image:
<br style="clear:left" />
MRI olfactory meningioma Dr Frank Gaillard.jpg|Olfactory meningioma<ref name="r">Image courtesy of  Dr Frank Gaillard [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/olfactory-groove-meningioma-3 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
[[File:Craniocervical-junction-meningioma.jpg|400px|thumb|left|MRI showing meningioma in the craniocervical junction [https://radiopaedia.org/articles/meningioma?lang=us source:Case courtesy of Dr Mohammad Taghi Niknejad, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. ]]]
 
<br style="clear:left" />
Image:
[[File:Multiple-meningiomas-1.jpg|400px|thumb|left|MRI showing multiple meningiomas [https://radiopaedia.org/articles/meningioma?lang=us source:Case courtesy of Dr Paresh K Desai , <a href="https://radiopaedia.org/">Radiopaedia.org</a>. ]]]
MRI meningioma cystic Dr Frank Gaillard.jpg|Cystic meningioma<ref name="r">Image courtesy of  Dr Frank Gaillard [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/images/880 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
<br style="clear:left" />
 
[[File:Meningioma-with-dural-tail.jpg|400px|thumb|left|MRI showing meningioma with a dural tail [https://radiopaedia.org/articles/meningioma?lang=us source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. ]]]
Image:
<br style="clear:left" />
MRI meningioma dural tail sign Dr Frank Gaillard.jpg|Meningioma dural tail sign<ref name="r">Image courtesy of  Dr Frank Gaillard [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/meningioma-with-dural-tail "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
[[File:Intraventricular-meningioma-third-ventricle-1.jpg|400px|thumb|left|MRI showing a meningioma in the third ventricle [https://radiopaedia.org/articles/meningioma?lang=us source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. ]]]
 
<br style="clear:left" />
Image:
MRI meningioma with vascular pedicle Dr Frank Gaillard.jpg|Meningioma with vascular pedicle<ref name="r">Image courtesy of  Dr Frank Gaillard [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/images/13090 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC] </ref>
 
Image:
MRI meningioma falx Dr Hani Al Salam.jpg|Meningioma falx<ref name="r">Image courtesy of  Dr Hani Al Salam [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/images/303566 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
 
Image:
MRI invasive meningioma Dr Bita Abbasi.jpeg|Invasive meningioma<ref name="r">Image courtesy of    Dr Bita Abbas [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/meningioma-invasive-1 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref>
 
</gallery>


==References==
==References==

Latest revision as of 14:38, 10 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2] Haytham Allaham, M.D. [3]

Overview

MRI with gadolinium is the investigation of choice for the diagnosis of meningioma. On MRI, meningioma is characterized by a homogeneous, well circumscribed, and extra-axial mass with a broad dural base. Other findings on MRI suggestive of meningioma include CSF vascular cleft sign, dural tail sign, and central necrosis or calcification that do not enhance. Meningiomas may appear different on T1 and T2-weighted sequence but with a few similarities.

MRI

Head MRI may be helpful in the diagnosis of meningioma. Findings on MRI suggestive of/diagnostic of meningioma include:[1]

  • 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

Gallery

MRI showing meningioma in the cerebellopontine angle source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.


MRI showing cystic meningioma source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.


MRI showing meningioma in the craniocervical junction source:Case courtesy of Dr Mohammad Taghi Niknejad, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.


MRI showing multiple meningiomas source:Case courtesy of Dr Paresh K Desai , <a href="https://radiopaedia.org/">Radiopaedia.org</a>.


MRI showing meningioma with a dural tail source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.


MRI showing a meningioma in the third ventricle source:Case courtesy of A.Prof Frank Gaillard, <a href="https://radiopaedia.org/">Radiopaedia.org</a>.


References

  1. ↑ 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.


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