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Microcystic Meningiomas: MRI‐Pathologic Correlation
Author(s) -
Kulanthaivelu Karthik,
Lanka Vivek,
Chandran Chitra,
Nandeesh Bevinhalli N.,
Tiwari Sarbesh,
Mahadevan Anita,
Prasad Chandrajit,
Saini Jitender,
Bhat Maya D.,
Chakrabarti Dhritiman,
Pruthi Nupur,
Vazhayil Vikas,
Sadashiva Nishanth,
Srinivas Dwarakanath
Publication year - 2020
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12743
Subject(s) - medicine , histopathology , magnetic resonance imaging , edema , lesion , reticular connective tissue , pathology , pathological , diffusion mri , neuroimaging , radiology , nuclear medicine , psychiatry
Background and Purpose Microcystic meningiomas (MM) are a distinctive, rare subtype of Grade I meningiomas with limited radiological descriptions. We intend to identify unique imaging phenotypes and seek radiopathological correlations. Methods Retrospective analysis of histopathologically proven MM was undertaken. Clinicodemographic profiles, imaging, and histopathological characteristics were recorded. Spearman rank correlations among radiological and pathological attributes were performed. Results Twenty‐eight cases were analyzed (mean age = 45.5 years; M:F = 1:1.54; mean volume = 50.1 mL; supratentorial n = 27). Most lesions were markedly T2 hyperintense (higher than peritumoral brain edema—a unique finding) (89.3%) and showed invariable diffusion restriction, severe peritumoral brain edema (edema index >2 in 64.3%), a “storiform” pattern on T2‐weighted images (T2WI) (75%), reticular pattern on postcontrast T1 (78.6%)/diffusion‐weighted images (DWI) (65.4%), hyperperfusion, T1 hypointensity (84.6%), and absence of blooming on susceptibility‐weighted image (80.9%). Storiform/reticular morphology correlated with large cysts on histopathology ( ρ = .56; P = .005753). Lesion dimension positively correlated with reticular morphology on imaging ( ρ = .59; P = .001173), higher flow voids ( ρ = .65; P = .00027), and greater microcystic changes on histopathology ( ρ = .51; P = .006778). Peritumoral brain edema was higher for lesions demonstrating greater angiomatous component ( ρ = .46; P = .014451). Conclusions We have elucidated varied neuroimaging features and highlighted pathological substrates of crucial imaging findings of MM. MM ought to be considered as an imaging possibility in an extra‐axial lesion with a marked hypodensity on noncontrast computed tomography, markedly T2‐hyperintense/T1‐hypointense signal, and a storiform/reticular pattern on T2W/GdT1w//DWI.