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Year : 2014  |  Volume : 10  |  Issue : 2  |  Page : 387-389

An atypical meningioma demystified and advanced magnetic resonance imaging techniques

1 Department of Radiology, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
2 Department of Neuroradiology, University Hospital of Zürich, Zürich, Switzerland
3 Department of Neurosurgery, Democritus University of Thrace Medical School, Alexandroupolis, Greece
4 Department of Pathology, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece

Correspondence Address:
Georgios K Matis
10 Plattenstrasse, Room 1401, CH-8032, Zürich
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.136666

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A 40-year-old male presented with visuospatial processing disturbances. Family history was free. Conventional and advanced magnetic resonance imaging (MRI) studies were performed. On T2 and fluid attenuation inversion recovery images, an increased signal intensity extra-axial lesion was demonstrated. Post-contrast scans depicted homogeneous intense contrast medium enhancement. T2* star sequence was negative for hemorrhagic or calcification foci. Diffusion-weighted imaging findings were indicative of malignant behavior and magnetic resonance venography confirmed superior sagittal sinus infiltration. Increased cerebral blood volume values were observed and peri-lesional oedema on perfusion-weighted imaging was also demonstrated. The signal intensity-time curve depicted the characteristic meningioma pattern. Spectroscopy showed increased choline and alanine levels, but decreased N-acetyl-aspartate levels. Conventional MRI is adequate for typical types of meningiomas. However, the more atypical ones, in which even the histopathologic specimen may demonstrate characteristics of typical meningioma, could be easier diagnosed with advanced MRI techniques.

Abstract in Chinese

用先进的磁共振成像技术揭示一例非典型脑膜瘤 摘要 一位40岁的男性产生了视觉空间成像混乱现象。家族史阴性。对其实施了常规的和先进的磁共振成像(MRI)研究。T2加权和液体衰减反转恢复图像,信号强度增加了额外的轴向病变。增强扫描中造影剂增强均匀。T2 *星序列为出血或钙化灶阴性。弥散加权成像结果显示恶性行为和磁共振静脉造影证实上矢状窦浸润。增加的脑血容量值被观察到,皮损周围水肿灌注加权成像也被证实。信号强度-时间曲线的描绘性脑膜瘤模式。光谱表明增加胆碱和丙氨酸水平,但降低N-乙酰天门冬氨酸水平。常规MRI足够诊断典型类型的脑膜瘤。然而,对于非典型病例,尤其组织病理学表现与典型脑膜瘤相似的,先进的磁共振成像技术使诊断变得更容易。 关键词:非典型脑膜瘤,弥散加权成像,功能磁共振成像,磁共振成像,磁共振波谱,灌注加权成像

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