MR elastography and perfusion MRI characterize distinct biomechanical and vascular features of meningiomas

To determine whether MR elastography (MRE) and dynamic susceptibility contrast (DSC) perfusion MRI provide overlapping or complementary information in meningiomas using anatomically matched regions of interest (ROIs).

Fifty-five patients with histopathologically confirmed meningiomas who underwent preoperative 3-T MRE and DSC perfusion MRI were retrospectively analyzed. MRE-derived stiffness and relative cerebral blood volume (rCBV) were evaluated in whole-tumor, MRE-defined high-stiffness (local), and non-focal ROIs. Regional differences, histological subtype associations, stiffness-perfusion correlations, and the influence of calcification were assessed.

MRE-derived stiffness was higher in the local than non-focal ROI (p < 0.001), whereas rCBV did not differ significantly (p = 0.274). MRE-derived stiffness and rCBV were not significantly correlated in the local, whole-tumor, or non-focal ROIs (ρ = 0.085-0.182; all p ≥ 0.183). Fibroblastic meningiomas showed lower local rCBV than meningothelial meningiomas (median, 4.01 vs. 9.87; p = 0.004), whereas MRE-derived stiffness did not differ significantly among histological subtypes (local p = 0.748). In the fibroblastic-meningothelial comparison, the stiffness effect size was small with a confidence interval spanning zero (r = - 0.126; 95% bootstrap CI, - 0.51 to 0.29). SWI-detected calcification was associated with lower rCBV but not MRE-derived stiffness.

Perfusion did not differ significantly between MRE-defined high-stiffness and non-focal regions, and no significant stiffness-rCBV association was detected across ROI types. Perfusion MRI nevertheless demonstrated histological subtype-related differences not observed with MRE-derived stiffness, suggesting that the two modalities provide different, potentially complementary information about meningioma biomechanical and vascular features.