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Tsutsumi S, Sugiyama N, Ueno H, Ishii H. Chordae Willisii of the dural sinuses: an anatomical study using magnetic resonance imaging. Surg Radiol Anat 2024:10.1007/s00276-024-03382-1. [PMID: 38733404 DOI: 10.1007/s00276-024-03382-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE The chordae Willisii (CWs), trabecular projections into the lumen of the dural sinuses, are not well understood. We aimed to explore them using magnetic resonance imaging (MRI). METHODS Eighty-five patients underwent volumetric contrast-enhanced MRI, while another 30 underwent a fluid-attenuated inversion recovery (FLAIR) sequence in the coronal section. RESULTS The CWs were detected as linear filling defects lying in the dural sinuses, adjacent to the surrounding dura mater. They were found in the superior sagittal sinus (SSS) in 68.2% of the patients, most frequently in the middle third, with laminar appearance. In 27.1% of the patients, the CWs divided the SSS lumen into separate channels. The CWs were identified in the transverse sinus, transverse-sigmoid sinus junctional area and sigmoid sinus, and straight sinus in 54.1, 47.1, and 8.2%, respectively. On the FLAIR images, dural septi partially dividing the SSS lumen were identified in all patients. In addition, in 73.3% of the patients, fine linear structures were observed in the lumen with inconstant arrangements. CONCLUSIONS The CWs may be constant structures distributed over the lumen of the intracranial dural sinuses. Contrast-enhanced MRI may be useful for detecting laminar CWs. The FLAIR sequence may be advantageous for delineating the dural septi projecting into the lumen of the dural sinuses.
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Affiliation(s)
- Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
| | - Natsuki Sugiyama
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Hideaki Ueno
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
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Automatic Meningioma Segmentation and Grading Prediction: A Hybrid Deep-Learning Method. J Pers Med 2021; 11:jpm11080786. [PMID: 34442431 PMCID: PMC8401675 DOI: 10.3390/jpm11080786] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/07/2021] [Accepted: 08/11/2021] [Indexed: 02/05/2023] Open
Abstract
The purpose of this study was to determine whether a deep-learning-based assessment system could facilitate preoperative grading of meningioma. This was a retrospective study conducted at two institutions covering 643 patients. The system, designed with a cascade network structure, was developed using deep-learning technology for automatic tumor detection, visual assessment, and grading prediction. Specifically, a modified U-Net convolutional neural network was first established to segment tumor images. Subsequently, the segmentations were introduced into rendering algorithms for spatial reconstruction and another DenseNet convolutional neural network for grading prediction. The trained models were integrated as a system, and the robustness was tested based on its performance on an external dataset from the second institution involving different magnetic resonance imaging platforms. The results showed that the segment model represented a noteworthy performance with dice coefficients of 0.920 ± 0.009 in the validation group. With accurate segmented tumor images, the rendering model delicately reconstructed the tumor body and clearly displayed the important intracranial vessels. The DenseNet model also achieved high accuracy with an area under the curve of 0.918 ± 0.006 and accuracy of 0.901 ± 0.039 when classifying tumors into low-grade and high-grade meningiomas. Moreover, the system exhibited good performance on the external validation dataset.
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Koeller KK, Shih RY. Intradural Extramedullary Spinal Neoplasms: Radiologic-Pathologic Correlation. Radiographics 2020; 39:468-490. [PMID: 30844353 DOI: 10.1148/rg.2019180200] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
While intradural extramedullary spinal disease varies widely, identification of tumors in this location and their radiologic manifestations greatly facilitates narrowing of the diagnostic considerations. Meningioma and schwannoma are the two most common intradural extramedullary tumors, and both are associated with neurofibromatosis. Meningiomas are most common in the thoracic spine and show a strong female predilection and a clinical manifestation related to compression of the spinal cord or nerve roots. Schwannomas typically are associated with radicular pain and other sensory symptoms. Melanotic schwannoma frequently shows T1 hyperintensity at MRI related to the presence of paramagnetic free radicals in melanin. Neurofibroma, known for its T2 hyperintensity, frequently involves the cervical spine, where it may make surgical resection challenging. Less commonly, malignant peripheral nerve sheath tumor commonly mimics the imaging appearance of a schwannoma but has decidedly more aggressive biologic behavior. In the cauda equina, myxopapillary ependymoma and paraganglioma are believed to arise from the filum terminale and have characteristic imaging manifestations based on their underlying pathologic features. Recent identification of a common genetic marker has led to reclassification of what had previously been regarded as separate tumors and are now known as solitary fibrous tumor/hemangiopericytoma. In the proper clinical setting, the presence of nodular intradural enhancement strongly suggests the presence of leptomeningeal metastatic disease, even when results of cerebrospinal fluid analysis are negative. This article highlights the characteristic neuroimaging manifestations of these neoplasms, with emphasis on radiologic-pathologic correlation. See Illumination by Frazier .
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Affiliation(s)
- Kelly K Koeller
- From the Department of Neuroradiology, American Institute for Radiologic Pathology, 1011 Wayne Ave, Suite 320, Silver Spring, MD 20910 (K.K.K., R.Y.S.); Department of Radiology, Mayo Clinic, Rochester, Minn (K.K.K.); Uniformed Services University of the Health Sciences, Bethesda, Md (R.Y.S.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (R.Y.S.)
| | - Robert Y Shih
- From the Department of Neuroradiology, American Institute for Radiologic Pathology, 1011 Wayne Ave, Suite 320, Silver Spring, MD 20910 (K.K.K., R.Y.S.); Department of Radiology, Mayo Clinic, Rochester, Minn (K.K.K.); Uniformed Services University of the Health Sciences, Bethesda, Md (R.Y.S.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (R.Y.S.)
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Meningioma mimics: five key imaging features to differentiate them from meningiomas. Clin Radiol 2017; 72:722-728. [PMID: 28554578 DOI: 10.1016/j.crad.2017.05.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 03/08/2017] [Accepted: 05/02/2017] [Indexed: 01/10/2023]
Abstract
There are a wide variety of intracranial mass lesions, both benign and malignant, which can closely mimic meningioma on imaging. We present five characteristic imaging features that can alert the radiologist to consider other differential diagnoses. Of the five imaging characteristics that were rarely seen in meningiomas, but common and specific for meningioma mimics, absence of dural tail is the most common (83.7%). Homogeneous T2 hyperintensity or T2 hypointensity are seen in nearly half of meningioma mimics and osseous destruction and leptomeningeal extension are present in 40.5% and 21.6% of meningioma mimics, respectively. The distinction between meningioma and its mimics is important because a large portion of the meningioma mimics requires substantially different clinical and surgical management.
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Goldbrunner R, Minniti G, Preusser M, Jenkinson MD, Sallabanda K, Houdart E, von Deimling A, Stavrinou P, Lefranc F, Lund-Johansen M, Moyal ECJ, Brandsma D, Henriksson R, Soffietti R, Weller M. EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol 2016; 17:e383-91. [PMID: 27599143 DOI: 10.1016/s1470-2045(16)30321-7] [Citation(s) in RCA: 523] [Impact Index Per Article: 65.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 02/08/2023]
Abstract
Although meningiomas are the most common intracranial tumours, the level of evidence to provide recommendations for the diagnosis and treatment of meningiomas is low compared with other tumours such as high-grade gliomas. The meningioma task force of the European Association of Neuro-Oncology (EANO) assessed the scientific literature and composed a framework of the best possible evidence-based recommendations for health professionals. The provisional diagnosis of meningioma is mainly made by MRI. Definitive diagnosis, including histological classification, grading, and molecular profiling, requires a surgical procedure to obtain tumour tissue. Therefore, in many elderly patients, observation is the best therapeutic option. If therapy is deemed necessary, the standard treatment is gross total surgical resection including the involved dura. As an alternative, radiosurgery can be done for small tumours, or fractionated radiotherapy in large or previously treated tumours. Treatment concepts combining surgery and radiosurgery or fractionated radiotherapy, which enable treatment of the complete tumour volume with low morbidity, are being developed. Pharmacotherapy for meningiomas has remained largely experimental. However, antiangiogenic drugs, peptide receptor radionuclide therapy, and targeted agents are promising candidates for future pharmacological approaches to treat refractory meningiomas across all WHO grades.
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Affiliation(s)
- Roland Goldbrunner
- Center of Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany.
| | - Giuseppe Minniti
- Radiation Oncology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy
| | - Matthias Preusser
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Michael D Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Kita Sallabanda
- Department of Neurosurgery, University Hospital San Carlos, Universidad Cumplutense de Madrid, Madrid, Spain; Department of Oncologia Radioterapia Robotizada-CyberKnife, IMOncology Madrid Arturo Soria, Madrid, Spain
| | | | - Andreas von Deimling
- Department of Neuropathology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany; CCU Neuropathology German Cancer Center (DKFZ), Heidelberg, Germany
| | - Pantelis Stavrinou
- Center of Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Florence Lefranc
- Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Morten Lund-Johansen
- Department of Neurosurgery, Bergen University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | | | - Dieta Brandsma
- Department of Neuro-Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Roger Henriksson
- Regional Cancer Centre Stockholm, Stockholm, Sweden; Department of Radiation Science and Oncology, University of Umeå, Umeå, Sweden
| | - Riccardo Soffietti
- Department of Neuro-Oncology, City of Health and Science University Hospital, Turin, Italy
| | - Michael Weller
- Department of Neurology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
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Qureshi AI, Lobanova I, Ullah N, Sohail A, Zafar TA, Malik AM, Qureshi MH. Prevalence of and Factors Associated with Dural Thickness in Patients with Mild Cognitive Impairment and Alzheimer's Disease. JOURNAL OF VASCULAR AND INTERVENTIONAL NEUROLOGY 2015; 8:68-73. [PMID: 26301035 PMCID: PMC4535597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND PURPOSE We performed this study to evaluate the prevalence of and factors associated with dural thickening in patients with mild cognitive impairment and Alzheimer's disease. METHODS Alzheimer's disease neuroimaging initiative participants with axial FLAIR sequence magnetic resonance imaging (MRI) images were analyzed. Dural thickness was defined by a linear strip of hyperintense tissue signal along the dura mater observed in at least two different images without evidence of leptomeningeal involvement. RESULTS Dural thickening was seen in 83 (34%) of 242 persons analyzed (mean age [±SD] 74±7 years: 150 were men) with either mild cognitive impairment or Alzheimer's disease. The mini mental score was not different in persons with (26±0.3) and without (26±0.2) dural thickening (p = 0.6). The proportion of patients with moderate or severe cognitive impairment (defined by mini mental status score) was similar at baseline and at 12-month evaluations. The rates of annual progression according to Alzheimer's disease assessment scale (p = 0.06) and clinical dementia scale (p = 0.001) were higher in persons without dural thickening. The annual rate of volume loss in entorhinal cortex was higher among persons with dural thickening. CONCLUSIONS We found relatively high prevalence of dural thickening in patients with mild cognitive impairment and Alzheimer's disease.
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Affiliation(s)
| | | | | | - Amna Sohail
- Zeenat Qureshi Stroke Institute, St. Cloud, MN
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Slot KM, Verbaan D, Uitdehaag BMJ, Wesseling P, Sanchez E, Vandertop WP, Peerdeman SM. Can excision of meningiomas be limited to resection of tumor and radiologically abnormal dura mater? Neuronavigation-guided biopsies of dural tail and seemingly normal dura mater, with a review of the literature. World Neurosurg 2014; 82:e832-6. [PMID: 25009164 DOI: 10.1016/j.wneu.2014.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/02/2014] [Indexed: 12/01/2022]
Affiliation(s)
- K Mariam Slot
- Meningioma Group Amsterdam (MeGA), VU University Medical Center, Amsterdam, The Netherlands; Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
| | - Dagmar Verbaan
- Meningioma Group Amsterdam (MeGA), VU University Medical Center, Amsterdam, The Netherlands; Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- Meningioma Group Amsterdam (MeGA), VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Pieter Wesseling
- Meningioma Group Amsterdam (MeGA), VU University Medical Center, Amsterdam, The Netherlands; Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Esther Sanchez
- Meningioma Group Amsterdam (MeGA), VU University Medical Center, Amsterdam, The Netherlands; Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - W Peter Vandertop
- Meningioma Group Amsterdam (MeGA), VU University Medical Center, Amsterdam, The Netherlands; Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Saskia M Peerdeman
- Meningioma Group Amsterdam (MeGA), VU University Medical Center, Amsterdam, The Netherlands; Neurosurgical Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Mori H, Kunimatsu A, Abe O, Sasaki H, Takao H, Nojo T, Kawai K, Saito N, Ohtomo K. Diagnostic Ability of Fluid-Attenuated Inversion Recovery MR Imaging to Detect Remnant or Recurrent Meningiomas after Resection. Neuroradiol J 2012; 25:163-71. [PMID: 24028909 DOI: 10.1177/197140091202500202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2011] [Accepted: 01/31/2012] [Indexed: 01/16/2023] Open
Abstract
It has been suggested that a difference in signal intensity (SI) between the resection cavity and normal cerebrospinal fluid (CSF) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) in partially resected gliomas indicates subsequent or coincident tumor progression. We considered that this would hold true for resected meningiomas as well. Hence, we aimed to assess whether or not such a difference in the SI during the follow-up evaluation helps predict residual or recurrent tumor in resected meningiomas. We evaluated 63 patients with resected meningiomas. The SI within the resection cavity observed on FLAIR images was qualitatively and quantitatively assessed during follow-up. Qualitative analysis comprised visual comparison of the SI in the resection cavity with that of normal CSF by neuroradiologists. The SI in the resection cavity was quantitatively assessed by region of interest (ROI) analysis and normalized against the background noise and CSF SI. Normalized SI recorded during follow-up was compared with that recorded immediately after resection. Tumor progression was defined as a 20% or greater increase in the diameter of the longest residual or recurrent meningioma (Response Evaluation Criteria in Solid Tumors). The sensitivity and specificity of the elevated SI in the resection cavity for indicating residual or recurrent tumor were calculated. Qualitative analysis by FLAIR MRI showed that patients with remnant tumor following surgery had a prolonged SI increase in the resection cavity. Further, SI increase could not always be observed before recurrence, and both SI increase and regrowth remnant/recurrence could be detected in the same MRI examination. In resected meningiomas, leakage of tumor elements into the resection cavity, presumably tumor cells, manifests as an SI increase on FLAIR images and indicates residual or recurrent tumor. However, unlike the previous reports on partially resected gliomas, we concluded that the SI change does not always precede tumor progression or recurrence.
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Affiliation(s)
- H Mori
- Department of Radiology, Graduate School and Faculty of Medicine, The University of Tokyo; Tokyo, Japan -
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Sotoudeh H, Yazdi HR. A review on dural tail sign. World J Radiol 2010; 2:188-92. [PMID: 21161034 PMCID: PMC2999017 DOI: 10.4329/wjr.v2.i5.188] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 05/03/2010] [Accepted: 05/10/2010] [Indexed: 02/06/2023] Open
Abstract
“Dural tail sign” (DTS) which is a thickening of the dura adjacent to an intracranial pathology on contrast-enhanced T1 MR Images, was first thought to be pathognomonic of meningioma, however, many subsequent studies demonstrated this sign adjacent to various intra- and extra-cranial pathologies and in spinal lesions. In this paper we outline the history, accompanying pathologies and the differentiation and probable pathophysiology of DTS. We also discuss whether we can predict tumoral involvement of the dural tail before surgery and whether the dural tail adjacent to a tumor should be resected.
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Rokni-Yazdi H, Azmoudeh Ardalan F, Asadzandi Z, Sotoudeh H, Shakiba M, Adibi A, Ayatollahi H, Rahmani M. Pathologic significance of the "dural tail sign". Eur J Radiol 2008; 70:10-6. [PMID: 18294796 DOI: 10.1016/j.ejrad.2008.01.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2007] [Revised: 12/26/2007] [Accepted: 01/11/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The exact nature of the "dural tail sign" (thickening of the dura adjacent to the tumour in contrast enhanced T1-MRI imaging) is still not clearly established. In this study we tried to verify the histological appearance of the "dural tail sign" and probable correlation between different MRI findings and dural tail histology. MATERIAL AND METHODS In this study, 129 patients with intracranial lesions underwent MRI imaging with 1.5T scanner. The "dural tail sign" was defined using Goldsher et al. criteria. Size and pattern of enhancement of the tumour and adjacent dura was noted in MRI and in the pathologic samples, dural tail and the dura beneath the tumour was assessed. RESULTS In 30 cases, "dural tail sign" was evident on MRI, dural tail noted in 17 of these cases in histological samples (12 meningiomas, 3 pituitary adenomas and 2 schwannomas). All of them had vessel dilatation, 6 showed tumoural invasion, 4 demonstrated intravascular growth of the lesion and 1 showed inflammation of the dura. CONCLUSION In our study MRI findings failed to predict tumoural invasion of the dural tail in histologic samples and because of frequent presence of tumour nests in it, the dura matter should be resected as widely as possible.
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Affiliation(s)
- Hadi Rokni-Yazdi
- Department of Radiology and Imaging, Imam Khomeini Hospital, Keshavarz Boulevard, Medical Sciences/Tehran University, Tehran, Iran.
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Alorainy IA. Dural tail sign in spinal meningiomas. Eur J Radiol 2006; 60:387-91. [DOI: 10.1016/j.ejrad.2006.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 06/24/2006] [Accepted: 06/27/2006] [Indexed: 10/24/2022]
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Oner AY, Tokgöz N, Tali ET, Uzun M, Isik S. Imaging meningiomas: Is there a need for post-contrast FLAIR? Clin Radiol 2005; 60:1300-5. [PMID: 16291312 DOI: 10.1016/j.crad.2005.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Revised: 06/09/2005] [Accepted: 07/07/2005] [Indexed: 10/25/2022]
Abstract
AIM The aim of this study was to compare post-contrast fluid-attenuated inversion recovery (FLAIR) imaging with post-contrast T1-weighted images (T1WI) in depicting meningiomas. MATERIALS AND METHODS Twenty-nine patients with 46 meningiomas were included in this study. FLAIR and T1WI were obtained before and after intravenous administration of gadopentetate dimeglumine. The contrast enhancement degree, contrast enhancement pattern, lesion conspicuity, and the detection of the dural sign were compared between post-contrast FLAIR images and post-contrast T1WI. RESULTS The enhencement degree on FLAIR was equal or less than T1WI for all meningiomas. Among 46 meningiomas 38 (83%) enhanced homogeneously and eight (17%) inhomogeneously on T1WI. On contrast-enhanced FLAIR images, of the total 46 meningiomas 22 (48%) enhanced homogeneously, eight (17%) inhomogeneously, whereas 14 (30%) meningiomas showed a peripheral rim enhancement not observed on T1WI. Two (5%) meningiomas showed no contrast enhancement on post-contrast FLAIR images. Among the 14 meningiomas showing rim enhancement using FLAIR imaging, 12 (85%) were measured to be 2 cm or more in diameter. A dural tail sign was found in 16 (35%) and 23 (50%) meningiomas on post-contrast T1WI and FLAIR images, respectively. CONCLUSION In contrast to other extra-axial diseases, post-contrast FLAIR sequence was not found to be a valuable adjunct to contrast-enhanced T1WI in the depiction of meningiomas.
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Affiliation(s)
- A Y Oner
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey.
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Abstract
Autoimmune (lymphocytic) hypophysitis is a rare disease that should be considered in the differential diagnosis of any nonsecreting pituitary mass, especially when occurring during pregnancy or postpartum. We have analyzed 370 articles published from January 1962 to October 2004 and identified a total of 379 patients with primary lymphocytic hypophysitis. The present review synthesizes the clinical and research data reported in this body of scientific literature.
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Affiliation(s)
- Patrizio Caturegli
- Johns Hopkins Pathology, Ross 656, 720 Rutland Avenue, Baltimore, MD 21205, USA.
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