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[Dura thickening adjacent to intracranial, para-dural space-occupying lesions in MRI. Histologic correlation]
A Hutzelmann1, S Palmié, M Freund
1Klinik für Radiologische Diagnostik der Christian-Albrechts-Universitt zu Kiel.
Purpose:
With intracranial tumors a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA enhanced MR images. Thers we have attempted to evaluate a tumor infiltration of these enhancement on MRI.
Material And Methods:
This study included 50 patients, 19 patients had a dural thickening at the tumor base (13 meningiomas and 6 metastases), while 31 patient did not (12 meningiomas and 19 metastases). Studies included plane T2-weighted spin echo (SE) images as well as T1-weighted axial, coronal, or sagittal plains with and without contrast agent. Histopathological examinations, were done on the tumor base adjacent to the dura mater.
Results:
7 of 12 meningiomas showed a meningeal thickening on MRI with histopathologically proven tumor infiltration as did also 5 of 6 metastases. But 3 of 12 meningiomas and 15 of 19 metastases without dural thickening at the tumor base also showed tumor invasion into the dura mater.
Conclusion:
MR imaging is still not able to determine whether or not there is a dural infiltration of the tumors base because there was no correlation between MR images and histopathologic results. In conclusion, metastases adjacent to the dura infiltrate the dura mater in a higher percentage than meningiomas.
Insights
Magnetic Resonance Imaging (MRI) cannot reliably detect dural infiltration in intracranial tumors. Dural enhancement on MRI does not correlate with histopathological findings of tumor invasion.
Area of Science:
- Neuroradiology
- Oncology
- Pathology
Context:
- Intracranial tumors can present with adjacent dural enhancement on MRI.
- Dural involvement is critical for treatment planning and prognosis.
Purpose:
- To evaluate the accuracy of MRI in detecting dural infiltration by intracranial tumors.
- To assess the correlation between MRI findings and histopathological results of dural invasion.
Summary:
- This study analyzed 50 patients with intracranial tumors, examining dural thickening on MRI and correlating it with histopathology.
- MRI findings of dural thickening showed poor correlation with actual dural infiltration.
- Metastases demonstrated a higher rate of dural infiltration compared to meningiomas, irrespective of MRI findings.
Impact:
- Current MRI techniques are insufficient for definitively diagnosing dural infiltration.
- Findings highlight the need for improved imaging biomarkers for dural invasion in neuro-oncology.