Diagnostic Performance of Magnetic Resonance Imaging (MRI) in The Diagnosis of Intracranial Meningioma

Abstract

Background: Meningiomas are the most common non-glial tumours of the central nervous system, arise from the arachnoid cap cells of the arachnoid villi compressing the brain. It is generally considered slowly growing lesions, often with an indolent clinical course depending on the location. Meningiomas are often clinically detected when already of large size or with increasing age. However, with increasing availability of cranial imaging, incidentally discovered meningiomas are becoming more frequent. They can arise from dura at any site, most commonly the skull vault, and base (planum sphenoidale, sphenoid wing, petrous ridge cavernous sinus, perisellar region and clivus) and at dural reflexions (falx cerebri, tentorium cerebelli and dura of adjacent venous sinuses), less commonly optic nerve sheath and choroid plexus. As meningiomas may display different growth dynamics over time, the initial tumor volume may have a significant impact on the risk of clinically relevant progression and outcome. Proper evaluation and detection is pivotal for further management.

Purpose: To assess the role of MRI in diagnosis of intracranial meningomas.

Materials & method: This cross sectional study was conducted in Department of Radiology & Imaging, Dhaka Medical College Hospital, Dhaka during the period of July 2013 to June 2015. Patients with clinically suspected brain tumor referred to Department of Radiology & Imaging, DMCH for MRI imaging were enrolled for study. All these patients were evaluated by detailed history, physical examination and neurological evaluation. MRI was performed and diagnosis was suggested radiologically. Finally, MRI findings were correlated with histopathological

diagnosis. All the information collected in data sheet. Data was processed and analyzed with the

help of computer program SPSS and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Result was presented by tabulation and graphical presentation in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc.

Result: Among the 46 respondents, maximum 15(32.6%) patients were in the age group of 51-60 years. Mean age was 52.1±10.3 years. Out of 46 cases, 19(41.3%) were male and 27(58.7%) were female. Male – female ratio was 1:1.4. MRI diagnosis of meningioma revealed that among the 46 cases 40(87.0%) were meningioma, 4(8.7%) were acoustic schwannoma, 1(2.15%) was pituitary macroadenoma and 1(2.15%) was craniopharyngioma. Histopathological diagnosis of

meningioma shows that among the 46 cases 38(82.6%) were meningioma, 5(10.9%) were acoustic schwannoma, 2(4.3%) was pituitary macroadenoma and 1(2.15%) was craniopharyngioma. Diagnostic validity of MRI revealed that sensitivity, specificity, accuracy, positive predictive value and negative predictive value was 97.4%, 62.5%, 91.3%, 92.5% and 83.3% respectively.

Conclusion: Meningiomas are the most common intracranial tumors and their incidence increases with age, with a median age at diagnosis of 52.1 years. Present study concludes that MRI (T1WI, T2WI, FLAIR & post contrast T1WI) is a useful diagnostic modality in evaluation of intracranial meningioma.

J Dhaka Med Coll. 2025; 34(2) : 84-90