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The dural tail sign--beyond meningioma
A Guermazi1, F Lafitte, Y Miaux
1Department of Radiology, University of California, San Francisco, USA. ali.guermazi@synarc.com
Clinical Radiology
|January 25, 2005
Summary
The dural tail sign on MRI, often linked to meningioma, can indicate various brain disorders. This sign is not specific, requiring further tests for accurate diagnosis.
Area of Science:
- Neuroradiology
- Oncology
- Neuropathology
Background:
- The dural tail sign, characterized by linear meningeal thickening and enhancement adjacent to cranial mass lesions on contrast-enhanced MRI, is frequently associated with meningioma.
- Conflicting reports exist regarding its specificity for meningioma, necessitating a broader understanding of its differential diagnoses.
Purpose of the Study:
- To review and illustrate the diverse range of disorders presenting with the dural tail sign on magnetic resonance (MR) imaging.
- To emphasize that the dural tail sign is not pathognomonic for meningioma and to explore other potential causes.
Main Methods:
- Review of magnetic resonance (MR) imaging findings in patients with the dural tail sign.
- Analysis of histopathological and cerebrospinal fluid (CSF) data for differential diagnosis.
Main Results:
- The dural tail sign can be observed in a wide spectrum of conditions beyond meningioma.
- Identified causes include extra-axial lesions and peripherally located intra-axial lesions such as neuromas, chloromas, metastases, lymphoma, gliomas, pituitary diseases, granulomatous disorders, and Erdheim-Chester disease.
- The sign's specificity is limited, but lesion morphology, enhancement patterns, and presentation (solitary or multifocal) offer diagnostic clues.
Conclusions:
- The dural tail sign on contrast-enhanced MRI is not specific to meningioma.
- A comprehensive evaluation of imaging features, alongside cerebrospinal fluid analysis or biopsy-proven histology, is crucial for accurate diagnosis of the underlying pathology.