Meningioma other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

Other imaging studies for meningioma include magnetic resonance (MR) spectroscopy, magnetic resonance (MR) perfusion, and angiography. MR spectroscopy study for meningioma demonstrates elevated levels of alanine, glutamine, and choline, as well as a significantly reduced levels of N-acetylaspartate and creatine. MR perfusion study for meningioma demonstrates an elevated value of relative cerebral blood volume (rCBV). Angiography of meningioma demonstrates high vascularization of the tumor due to dual blood supply by both pial (intracranial) and meningeal (extracranial) vessels.

Other Imaging Findings

Diffusion weighted MRI

Diffusion MRI may be helpful in the diagnosis of meningioma. Findings on an diffusion MRI suggestive of/diagnostic of meningioma include:

• Reduced water diffusivity which is seen more in aggressive tumors and atypical/malignant meningiomas
• A decrease in the apparent diffusion coefficient raises suspicion that a tumor has differentiated to a higher grade on follow up of a benign meningioma.

Magnetic resonance spectroscopy

• Magnetic resonance (MR) spectroscopy imaging may help distinguish meningioma from other CNS masses. Features include:

• Elevated alanine level
• Elevated glutamine/glutamate level
• Elevated choline (Cho) level
• Absent or significantly reduced N-acetylaspartate (NAA) level
• Absent or significantly reduced creatine (Cr) level

Perfusion MRI

• Perfusion MRI may be helpful in the diagnosis of meningioma. Findings on an perfusion MRI suggestive of/diagnostic of meningioma include:

• Elevated relative cerebral blood volume (rCBV) value

Angiography

• Angiography of meningioma demonstrates:

• High vascularization of the tumor due to dual blood supply by both pial (intracranial) and meningeal (extracranial) vessels
• Spoke wheel appearance
• Dense venous filling

Gallery

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  Meningioma angiography demonstrating dural sinus invasion