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Microcystic meningiomas: radiological characteristics of 16 cases
1Department of Neurosurgery and Clinical Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Background:
As a rare subtype of meningioma, only a few reports deal with radiological characteristics of microcystic meningiomas and the problem remains controversial. The authors have analyzed the radiological findings of a series of microcystic meningiomas with a special focus on magnetic resonance images (MRI) and conventional angiography.
Method:
Sixteen patients of histologically proven microcystic meningiomas were included. Analysis of preoperative MRI including signal intensity characteristics, enhancement patterns and peritumoural edema were performed and correlated with angiographic and histological findings. Peritumoural edema was graded using edema index (EI) which was defined as the ratio of VE/VT.
Findings:
The tumours were uniformly visualized as a high-signal mass lesion in T2-weighted images and as a low-signal mass lesion in T1-weighted images regardless of tumour vascularity shown by angiography. T2-weighted images revealed that peritumoural brain edema was severe in 11, moderate in 1, mild in 2 and negligible in 2 patients and this was closely related to the co-existence of irregular tumour marginal enhancement. However, other features failed to distinguish these lesions from other subtypes of meningioma.
Conclusions:
The cases presented demonstrate that characteristic MRI findings suggestive of microcystic meningiomas are; (1) low signal intensity mass in T1- and high signal intensity mass in T2-weighted images; (2) high incidence of peritumoural edema.
Insights
Radiological characteristics of microcystic meningiomas show distinct magnetic resonance imaging (MRI) findings. These include low signal intensity on T1-weighted and high signal intensity on T2-weighted MRI, with a high incidence of peritumoural edema.
Area of Science:
- Neuroradiology
- Neuro-oncology
- Medical imaging
Background:
- Microcystic meningiomas are a rare subtype of meningioma.
- Radiological characteristics remain controversial and underreported.
- Limited studies focus on their specific imaging features.
Purpose of the Study:
- To analyze radiological findings of microcystic meningiomas.
- To focus on magnetic resonance imaging (MRI) and conventional angiography features.
- To correlate imaging findings with histological data.
Main Methods:
- Analysis of preoperative MRI in 16 histologically proven cases.
- Evaluation of signal intensity, enhancement patterns, and peritumoural edema.
- Correlation with angiographic and histological findings, using edema index (EI).
Main Results:
- Tumors uniformly appeared as low-signal on T1-weighted and high-signal on T2-weighted MRI.
- Peritumoural brain edema was common, with severe edema in 11 of 16 patients.
- Irregular tumor marginal enhancement correlated with severe edema; other features were non-specific.
Conclusions:
- Characteristic MRI findings include low T1 and high T2 signal intensity.
- A high incidence of peritumoural edema is suggestive of microcystic meningiomas.
- These findings aid in differentiating this rare meningioma subtype.
