Contribution of dynamic contrast MR imaging to the differentiation between dural metastasis and meningioma.
OBJECTIVE
To determine the perfusion-sensitive characteristics of cerebral dural metastases and compare them with the data on meningiomas.


METHODS
Twenty-two patients presenting with dural tumor underwent conventional and dynamic susceptibility-contrast MR imaging: breast carcinoma metastases, two patients; colorectal carcinoma metastasis, one patient; lung carcinoma metastasis, one patient; Merkel carcinoma metastasis, one patient; lymphoma, one patient; meningiomas, 16 patients. The imaging characteristics were analyzed using conventional MR imaging. The cerebral blood volume (CBV) maps were obtained for each patient and the relative CBV (rCBV) in different areas was calculated using the ratio between the CBV in the pathological area (CBVp) and in the contralateral white matter (CBVn).


RESULTS
The differentiation between a meningioma and a dural metastasis can be difficult using conventional MR imaging. The rCBVs of lung carcinoma metastasis (1 case: 1.26), lymphoma (1 case: 1.29), breast carcinoma metastasis (2 cases: 1.50,1.56) and rectal carcinoma metastasis (1 case: 3.34) were significantly lower than that of meningiomas (16 cases: mean rCBV = 8.97+/-4.34, range 4-18). Merkel carcinoma metastasis (1 case: 7.56) showed an elevated rCBV, not different from that of meningiomas.


CONCLUSIONS
Dural metastases are sometimes indistinguishable from meningiomas using conventional MR imaging. rCBV mapping can provide additional information by demonstrating a low rCBV which may suggest the diagnosis of metastasis.
Kremer
S
S
Neuroradiology Department, University Hospital, Nancy, France. kremers@club-internet.fr
Grand
S
S
Rémy
C
C
Pasquier
B
B
Benabid
A L
AL
Bracard
S
S
Le Bas
J F
JF
D001810:Blood Volume; D001943:Breast Neoplasms / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis* / Q000503:physiopathology / Q000556:secondary; D002560:Cerebrovascular Circulation; D003287:Contrast Media; D003937:Diagnosis, Differential; D004388:Dura Mater / Q000000981:diagnostic imaging; D019786:Gadolinium DTPA; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis* / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000556:secondary; D008579:Meningioma / Q000175:diagnosis* / Q000503:physiopathology; D011859:Radiography; D012004:Rectal Neoplasms / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology
D003287:Contrast Media; D019786:Gadolinium DTPA