[Imaging Features and Differential Diagnosis of Meningiomas and Their Mimics]

Area of Science:

• Neurology
• Radiology
• Oncology

Background:

• Meningiomas are the most common primary intracranial tumors, typically extra-axial and dural-based.
• Histological diversity leads to varied imaging presentations, complicating differential diagnosis.
• Accurate differentiation from mimickers is crucial for appropriate patient management.

Purpose of the Study:

• To outline key imaging mimickers of meningiomas.
• To aid clinicians in differentiating meningiomas from other pathologies with similar imaging findings.
• To improve diagnostic accuracy in cases of suspected meningioma.

Main Methods:

• Review of imaging findings for various dural-based masses and thickening.
• Comparison of characteristic imaging features of meningiomas versus their mimics.
• Identification of challenging cases due to secondary changes like metastasis or infarction.

Main Results:

• Mimicking diseases include schwannomas, solitary fibrous tumors, dural metastases, and histiocytosis for mass lesions.
• Dural thickening mimics include hypertrophic pachymeningitis, fungal infections, and IgG4-related disease.
• Metastasis and infarction can further complicate meningioma diagnosis.

Conclusions:

• Recognizing imaging mimickers is essential for accurate meningioma diagnosis.
• A broad differential diagnosis should be considered for dural-based lesions.
• Understanding variations in meningioma presentation aids in avoiding misdiagnosis.