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Evaluation of parenchymal collaterals in patients with meningioma using contrast-enhanced T1 MPRAGE sequence
Elif Gozgec1, Hayri Ogul2, Ibrahim Feyyaz Naldemir3
1Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Background:
Post-contrast T1-MPRAGE sequence has been used in routine tumor imaging at many centers for decades. Meningiomas may be accompanied by leptomeningeal as well as parenchymal collaterals. In this study, we aimed to demonstrate the collaterals that may accompany meningiomas on postcontrast T1-MPRAGE imaging and to investigate their relationship with location, size, histologic features, adjacent bone, and parenchymal changes.
Methods:
In this study, postcontrast T1-MPRAGE images of 326 meningiomas from 259 patients were independently analyzed by two observers. The presence of parenchymal collaterals and unilateral, contralateral or bilateral localization were determined. Meningiomas' diameters, locations, presence of dural sinus invasion, associated parenchymal changes and bony changes were determined. Histologic grades were determined if applicable. The data obtained were analyzed statistically.
Results:
Parenchymal collaterals were demonstrated in 25% of meningiomas (66/259). Of these, 65% were unilateral, 12% contralateral and 23% bilateral. There was a significant correlation between malignancy and the presence of collaterals in histologically diagnosed meningiomas (77%, p = 0.01). The presence of collaterals was also significantly higher in meningiomas with sinus invasion and bone destruction (p < 0.001). As tumor size increased, unilateral and bilateral collateral development increased (p < 0.001, p = 0.008, respectively), but it was not significant in contralateral cases. There was significant concordance between the observers in terms of the presence of collaterals (kappa: 0.773).
Conclusions:
Meningiomas may be accompanied by parenchymal collaterals. WHO grade 3 histologic type, sinus invasion, bone destruction and size increase are predictors of collateral development.
Insights
Parenchymal collaterals frequently accompany meningiomas, especially higher-grade tumors with sinus invasion or bone destruction. Tumor size also correlates with collateral development, aiding in diagnosis.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Post-contrast T1-MPRAGE imaging is standard for meningioma evaluation.
- Meningiomas can present with leptomeningeal and parenchymal collaterals.
Purpose of the Study:
- To identify parenchymal collaterals associated with meningiomas using post-contrast T1-MPRAGE.
- To explore the relationship between collaterals and meningioma characteristics.
Main Methods:
- Retrospective analysis of 326 meningiomas in 259 patients.
- Independent review of post-contrast T1-MPRAGE images for collateral presence and localization.
- Correlation with tumor size, location, histology, and bone/parenchymal changes.
Main Results:
- Parenchymal collaterals were present in 25% of meningiomas.
- Collaterals significantly correlated with higher tumor grade (77%), sinus invasion, and bone destruction.
- Increased tumor size was associated with unilateral and bilateral collateral development.
Conclusions:
- Parenchymal collaterals are a notable feature in meningiomas.
- WHO grade 3 histology, sinus invasion, bone destruction, and tumor size predict collateral development.
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