CT of meningiomas on the Posterior surface of the petrous bone

A detailed analysis of the CT findings in 16 surgically verified cases of meningioma of the posterior surface of the petrous bone is presented. The results indicate that a correct preoperative diagnosis is possible in almost every case. Frequently occurring specific CT criteria for meningioma of the posterior surface of the petrous bone include: hyperdense, homogeneously enhancing, extra-axial, CPA mass; inverse relationship between precontrast attenuation value and degree of contrast enhancement of the tumor; oval shape; obtuse angle between lateral tumor border and posterior surface of petrous bone, and evidence of transcisternal supratentorial tumor extension. Infrequently occurring specific CT criteria include: tumor calcification; hyperostosis or exostosis of the posterior surface of the petrous bone; a comma-shaped tumor configuration in cases with transcisternal tumor extension and evidence of transtentorial tumor extension. Oxygen CT cisternography is the most sensitive and reliable technique for detecting small tumors. The CT differential diagnosis of meningioma of the posterior surface of the petrous bone is discussed.