MRI of aggressive meningiomas.
The authors have attempted to establish by MRI morphological criteria for the so-called "aggressive" intracranial meningiomas. The MRI features of 20 meningiomas histologically aggressive (numerous mitoses and small necrotic foci) or malignant (same plus invasion of the subjacent brain tissue) were compared with those of a control population of 26 patients with benign meningioma. The site of the tumour and its histological type had little predictive value, but there was a remarkably high proportion of male patients in the group with aggressive meningioma (9/20 versus 2/26). More than other varieties, aggressive meningiomas frequently emitted, on both T1- and T2-weighted sequences, a heterogeneous signal due to a necrotic focus (P less than 0.01). The high-intensity signal observed on T2-weighted sequences (11/20) was suggestive of syncitial or angioblastic meningioma. Cystic meningiomas were present in virtually equal proportions (3/20 versus 3/26) in the two populations and could raise problems concerning the diagnosis of nature, especially when intraventricular. Gadolinium injection provided further evidence of aggressiveness, such as irregular tumour outline or even contrast enhancement of brain tissue in malignant cases (3/4), but enhancement of the dura mater was equally frequent in both groups (P greater than 0.2). Massive peritumoral oedema was significantly more frequent in aggressive melanomas (P less than 0.01).
Drape
J L
JL
Service de Radiologie III, Hôpital de Hautepierre, Strasbourg, France.
Krause
D
D
Tongio
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001929:Brain Edema / Q000175:diagnosis; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness
D003287:Contrast Media; D005682:Gadolinium