Meningioma mimics: five key imaging features to differentiate them from meningiomas
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Objective To clarify evaluation methodology of the accuracy of differential diagnosis of meningioma and glioma,taking magnetic resonance imaging (MRI) and vascular endothelial growth factor (VEGF) into account.Methods According to the unified standard of design,114 cases were selected,which were diagnosed by postoperative pathological in Shanxi Cancer Hospital from March 2010 to October 2012.On the basis of hospital routine inspection,all patients needed MRI scan,enhancement scan,VEGF,ALP and LDH,with pathological diagnosis of glioma or meningioma.Using ROC curve analysis which took VEGF,T2WI into account,the accuracy of differential diagnosis could be evaluated.Results The results showed that the differential diagnosis accuracy were high relatively,the area under the ROC curve was 91.34 ％.When the T2WI were equisignal,low signal or high signal respectively,the area under the curve ROC were 97.62 ％,90.00 ％,88.34 ％.Conclusion To consider the MRI T2WI and VEGF,ROC curve regression model analysis can enhance the differential diagnosis accuracy of meningioma and glioma.
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Meningioma; Glioma; ROC curve; Vascular endothelial growth factor; Magnetic resonance imaging; Diagnosis, differential
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Objective To present CT, MRI and pathological findings of calcified psammomatous meningioma,so as to improve the diagnosis. Materials and Methods CT and MRI characteristic of 7 patients (2 males and 5 females,39 to 66 years old with the mean age of 56 years) with psammomatous meningioma proved by pathology were analyzed. Three patients underwent CT examination(two underwent enhanced scan),and 6 patients underwent MRI scan. Two patients were examined by both CT and MRI. Results Among 7 calcified psammomatous meningioma,2 cases showed calcification involved whole tumor,1 case showed thick circular calcifications,4 cases showed strip-like calcifications. The tumors displayed as hyper or iso-dense on CT images. The hyper-dense of the masses showed no enhancement after contrast injection. The masses were significant hypointensity,slight hypointensity or isointensity signal on T1WI and significant hypointensity,isointensity signal or slight hyperintensity on T2WI. All the masses enhanced heterogeneously after contrast material injection. Three cases showed dural tail sign. Conclusion Combined imaging findings of CT and MRI can provide more comprehensive information and improve the diagnosis of calcified psammomatous meningioma.
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A review of the impact of computerized axial tomography on the radiological diagnosis of meningiomas is presented. Seventy-one intracranial and eight orbital cases have been examined by this new method using the 160 × 160 matrix. The diagnostic accuracy of the method is compared with established neuroradiological methods of examination (plain X rays, angiography, pneumography and isotope scanning). The new non-invasive method is undoubtedly the most accurate diagnostic tool yet available. It provided a specific diagnosis of meningioma in 77% of the intracranial cases without contrast enhancement and diagnosed the presence of tumour in a further 19% giving an overall tumour diagnosis of 96%. There were three false negatives (4%). After intravenous injection of contrast medium specific diagnosis of meningioma was made in a further six cases raising the specific diagnostic rate to 86%. Specific identification of intra-orbital meningiomas is more difficult though the presence of retro-orbital tumour was correctly diagnosed in all eight cases examined (100%). In none of our cases was a false positive diagnosis of tumour made. However, there are areas where a specific diagnosis of meningioma can only be made as part of a wider differential diagnosis. Apart from the orbit these include the suprasellar area, the cerebello-pontine angle, and the intraventricular regions. Occasionally also supratentorial gliomas or secondaries can simulate meningiomas.
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We describe a patient with mesial temporal T2-weighted image hyperintensity on magnetic resonance imaging that mimicked paraneoplastic limbic encephalitis. The patient showed pupillary abnormalities suggestive of a diagnosis of neurosyphilis, and the diagnosis was supported by the results of a serum Treponema pallidum hemagglutination assay (TPHA) and cerebrospinal fluid examination. Making a diagnosis of neurosyphilis is occasionally difficult because of the variety of clinical and imaging findings. Appropriate diagnosis and commencing adequate treatment are needed for a good prognosis; thus, neurosyphilis should be included in the differential diagnosis of mesiotemporal magnetic resonance imaging abnormalities.
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ObjectiveTo characterize gliomatosis cerebri on magnetic resonance imaging (MRI) and analyze differential diagnosis.MethodsMRI studies of 12 patients with gliomatosis cerebri were reviewed.ResultsTumors involved at least two lobes of the brain in all patients. Widespread invasion with hyperintensity was noted on T_2-weighted MR images. No contrast enhancement occurred.Tumors were confirmed with surgery or biopsy.ConclusionGliomatosis cerebri is best detected with MRI.
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