Meningioma other imaging findings: Difference between revisions

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{{Meningioma}}
{{Meningioma}}
{{CMG}} {{AE}}{{HL}}
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==Overview==
==Overview==
Other imaging studies for meningioma include magnetic resonance (MR) spectroscopy, magnetic resonance (MR) perfusion, and [[angiography]].<ref name="R"> Meningioma. Radiopaedia(2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref> 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).<ref name="pmid21061142">{{cite journal| author=Zimny A, Sasiadek M| title=Contribution of perfusion-weighted magnetic resonance imaging in the differentiation of meningiomas and other extra-axial tumors: case reports and literature review. | journal=J Neurooncol | year= 2011 | volume= 103 | issue= 3 | pages= 777-83 | pmid=21061142 | doi=10.1007/s11060-010-0445-9 | pmc=PMC3116130 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21061142  }} </ref> Angiography of meningioma demonstrates high vascularization of the [[tumor]] due to dual blood supply by both [[pial]] (intracranial) and [[meningeal]] (extracranial) vessels.<ref name="R"> Meningioma. Radiopaedia(2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref>
Other imaging studies that may be helpful in the diagnosis of meningioma include magnetic resonance (MR) spectroscopy, perfusion MRI, and diffusion MRI. With MR spectroscopy, elevated levels of alanine, choline, and/or lactate could be seen. MR perfusion study could demonstrate an elevated value of relative [[cerebral]] blood volume (rCBV).


==Other Imaging Findings==
==Other Imaging Findings==
====Magnetic resonance spectroscopy====
* Magnetic resonance (MR) spectroscopy imaging may help distinguish meningioma from other [[CNS]] masses. Features include:<ref name="R"> Meningioma. Radiopaedia(2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref>
:* 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


====Magnetic resonance perfusion====
===Diffusion Weighted MRI===
* Magnetic resonance (MR) perfusion imaging may distinguish meningioma from other differential diagnosis. Features include:<ref name="pmid21061142">{{cite journal| author=Zimny A, Sasiadek M| title=Contribution of perfusion-weighted magnetic resonance imaging in the differentiation of meningiomas and other extra-axial tumors: case reports and literature review. | journal=J Neurooncol | year= 2011 | volume= 103 | issue= 3 | pages= 777-83 | pmid=21061142 | doi=10.1007/s11060-010-0445-9 | pmc=PMC3116130 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21061142 }} </ref>
Diffusion MRI may be helpful in the diagnosis of meningioma. Findings on an diffusion MRI suggestive of/diagnostic of meningioma include:<ref name="pmid20809250">{{cite journal| author=Saloner D, Uzelac A, Hetts S, Martin A, Dillon W| title=Modern meningioma imaging techniques. | journal=J Neurooncol | year= 2010 | volume= 99 | issue= 3 | pages= 333-40 | pmid=20809250 | doi=10.1007/s11060-010-0367-6 | pmc=2945460 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20809250 }} </ref>
:* Elevated relative [[cerebral]] blood volume (rCBV) value
*Reduced water diffusivity which is seen more in aggressive tumors and atypical/malignant meningiomas
:* Time-intensity curve illustrates a sharp signal drop from baseline with no return to baseline measures
*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.


====Angiography====
====Magnetic Resonance Spectroscopy====
* Angiography of meningioma demonstrates:<ref name="R"> Meningioma. Radiopaedia(2015) http://radiopaedia.org/articles/meningioma Accessed on September, 25 2015</ref>
Magnetic resonance spectroscopy may be helpful in the diagnosis of meningioma. Findings on an MR spectroscopy suggestive of/diagnostic of meningioma include:<ref name="pmid16844335">{{cite journal| author=Demir MK, Iplikcioglu AC, Dincer A, Arslan M, Sav A| title=Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas. | journal=Eur J Radiol | year= 2006 | volume= 60 | issue= 1 | pages= 48-55 | pmid=16844335 | doi=10.1016/j.ejrad.2006.06.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16844335  }} </ref>
:* High vascularization of the [[tumor]] due to dual blood supply by both [[pial]] (intracranial) and [[meningeal]] (extracranial) vessels
:* Elevated [[alanine]]    
:* Spoke wheel appearance
:* Elevated [[choline]] (Cho)  
:* Dense [[venous]] filling
:* Absent or significantly reduced N-acetylaspartate (NAA)
:* Absent or significantly reduced [[creatine]] (Cr)
:* Elevated lactate


==Gallery==
====Perfusion MRI====
 
Perfusion MRI may be helpful in the diagnosis of meningioma. Findings on an perfusion MRI suggestive of/diagnostic of meningioma include:<ref name="pmid21061142">{{cite journal| author=Zimny A, Sasiadek M| title=Contribution of perfusion-weighted magnetic resonance imaging in the differentiation of meningiomas and other extra-axial tumors: case reports and literature review. | journal=J Neurooncol | year= 2011 | volume= 103 | issue= 3 | pages= 777-83 | pmid=21061142 | doi=10.1007/s11060-010-0445-9 | pmc=PMC3116130 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21061142  }} </ref><ref name="pmid20809250">{{cite journal| author=Saloner D, Uzelac A, Hetts S, Martin A, Dillon W| title=Modern meningioma imaging techniques. | journal=J Neurooncol | year= 2010 | volume= 99 | issue= 3 | pages= 333-40 | pmid=20809250 | doi=10.1007/s11060-010-0367-6 | pmc=2945460 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20809250  }} </ref>
<gallery>
:* Elevated relative [[cerebral]] blood volume (rCBV) value
Image:
Angiography meningioma Dr Bruno Di Muzio.JPG|Meningioma angiography demonstrating dural sinus invasion<ref>Image courtesy of Dr Bruno Di Muzio [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/images/1227737 "here"]). [http://radiopaedia.org/licence Creative Commons BY-SA-NC]      </ref>
</gallery>


==References==
==References==
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Latest revision as of 20:01, 29 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2] Haytham Allaham, M.D. [3]

Overview

Other imaging studies that may be helpful in the diagnosis of meningioma include magnetic resonance (MR) spectroscopy, perfusion MRI, and diffusion MRI. With MR spectroscopy, elevated levels of alanine, choline, and/or lactate could be seen. MR perfusion study could demonstrate an elevated value of relative cerebral blood volume (rCBV).

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:[1]

  • 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 spectroscopy may be helpful in the diagnosis of meningioma. Findings on an MR spectroscopy suggestive of/diagnostic of meningioma include:[2]

  • Elevated alanine
  • Elevated choline (Cho)
  • Absent or significantly reduced N-acetylaspartate (NAA)
  • Absent or significantly reduced creatine (Cr)
  • Elevated lactate

Perfusion MRI

Perfusion MRI may be helpful in the diagnosis of meningioma. Findings on an perfusion MRI suggestive of/diagnostic of meningioma include:[3][1]

  • Elevated relative cerebral blood volume (rCBV) value

References

  1. 1.0 1.1 Saloner D, Uzelac A, Hetts S, Martin A, Dillon W (2010). "Modern meningioma imaging techniques". J Neurooncol. 99 (3): 333–40. doi:10.1007/s11060-010-0367-6. PMC 2945460. PMID 20809250.
  2. Demir MK, Iplikcioglu AC, Dincer A, Arslan M, Sav A (2006). "Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas". Eur J Radiol. 60 (1): 48–55. doi:10.1016/j.ejrad.2006.06.002. PMID 16844335.
  3. Zimny A, Sasiadek M (2011). "Contribution of perfusion-weighted magnetic resonance imaging in the differentiation of meningiomas and other extra-axial tumors: case reports and literature review". J Neurooncol. 103 (3): 777–83. doi:10.1007/s11060-010-0445-9. PMC 3116130. PMID 21061142.