Microcystic meningioma: Two cases examined with perfusion-weighted imaging

Abstract Purpose Microcystic meningioma is a rare morphological variant of meningioma with multiple radiological presentations. To date only the findings on CT and conventional MRI have been described. We report two cases of microcystic meningioma examined with perfusion-weighted MR. Methods Two patients with a cystic meningioma were examined with gradient-echo perfusion MR. Results A convexity microcystic meningioma showed low rCBV in one patient. In the other patient with a microcystic falx meningioma high rCBV was noted, probably reflecting hypervascularity, but also impaired venous outflow and contrast-medium leakage. The vascularity of the tumor as demonstrated by perfusion MR correlated well with the intra-operative findings. Conclusion The vascularity of microcystic menigioma seems variable and multifactorial. In our two patients rCBV correlated well with intra-operative findings. Further larger studies will have to confirm that perfusion MR can predict the vascularity of a meningioma with cystic appearance.