Meningioma

meningioma

History: 50 female. Uncertain presentation.
Radiologic findings: Heterogeneous hypo- to isointensity on T1WI with avid enhancement post gadolinilum. “Dural tail”- curvilinear area of enhancement tapering off from margin of tumour along dural surface. Hyperostosis of adjacent bone.
Other possible imaging findings: CT – calcification, dense pre-contrast, “light-bulb” enhancement post contrast; MRS – alanine; DSA – “mother-in-law” sign (contrast shows up early and stays late), ECA supply commonest, “spoke-wheel” vascularity.
Incidence: Commonest extra-axial tumour; 15-18% of adult intracranial tumours.
Origin: Derived from meningothelial cells concentrated in arachnoid villi.
Age: Peak incidence 45 years (range 35-70 years).
Associations: Neurofibromatosis type II (10% of patients with multiple meningiomas have NF II); basal cell naevus syndrome.

References:
1. Dahnert W. Radiology Review Manual, 5th edition. Lippincott, Williams and Wilkins 2003.
2. Grossman R, Yousem D. Neuroradiology: The Requisites, 2nd edition. Mosby 2003.

Credit: Dr Marina-Portia Anthony