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Intracranial meningiomas: correlations between MR imaging and histology

F Maiuri1, G Iaconetta, O de Divitiis

  • 1Institute of Neurosurgery, School of Medicine, Clinica Neurochirurgica, Facoltá di Medina e Chiruriga, Universita degli Studi Federico II, Naples, Italy.

Insights

Magnetic resonance imaging (MRI) can help differentiate intracranial meningiomas. T2-weighted MRI signals correlate with tumor subtype, vascularity, and consistency, aiding preoperative diagnosis.

Area of Science:

  • Neuroimaging
  • Neuropathology
  • Oncology

Background:

  • Intracranial meningiomas are common primary tumors of the central nervous system.
  • Accurate preoperative characterization of meningiomas is crucial for surgical planning and patient management.
  • Histopathological subtypes of meningiomas exhibit diverse clinical and radiological features.

Purpose of the Study:

  • To investigate the correlation between magnetic resonance imaging (MRI) signal characteristics and histopathological features of intracranial meningiomas.
  • To determine the utility of MRI in predicting tumor subtype, vascularity, and consistency.
  • To assess the value of T1- and T2-weighted MRI sequences in preoperative meningioma characterization.

Main Methods:

  • Retrospective analysis of 35 surgically verified intracranial meningiomas.
  • Correlation of MRI findings (T1- and T2-weighted images) with histopathological subtypes.
  • Evaluation of signal intensities relative to brain cortex and assessment of tumor characteristics like cysts and vascularity.

Main Results:

  • T1-weighted images showed similar tumor signals across histologic subtypes.
  • T2-weighted images revealed distinct signal patterns: hypointense tumors were predominantly fibroblastic, hyperintense tumors were syncytial/angioblastic, and isointense tumors were transitional.
  • Hyperintense T2 tumors were soft, vascular, and syncytial/angioblastic; hypointense/hypo-isointense T2 tumors were hard and fibroblastic/transitional.

Conclusions:

  • MRI signal intensity, particularly on T2-weighted images, is a valuable tool for preoperative characterization of intracranial meningiomas.
  • T1-weighted MRI can predict the presence of cysts and intratumoral vessels.
  • T2-weighted MRI provides insights into histological subtype, vascularity, and tumor consistency, aiding in surgical planning.

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