BAHAN Radiologi meningioma

Clinical Overview: Meningioma is the

most common extraaxial brain tumor.
They represent 20% of all primary brain
tumors. They are most common in adults
and are usually asymptomatic. They can
arise in a radiation field many years after
irradiation.

As in this case, 5% are atypical and 1%

are malignant, having a much worse
prognosis.

CT: They are sharply circumscribed and lobulated mass that abuts the dura. The
are extraaxial thus forming an obtuse angle to the dura. This is a key observation in
making the diagnosis because they are the most common extraaxial brain mass.
Furethermore, the obtuse angle to the dura can be associated with a "dural tail" sign
which is highly suggestive of a meningioma differentiating it from other extraaxial
mass like a schwannoma (figure 1). On unenhanced CT, most of the time they are
denser than brain. 20% have calcifications. It enhances very brightly and
occasionally have a non-enhancing necrotic center. The amount of surrounding
edema varies. There is hyperostotic or osteolytic bony reaction in 20% of the cases.
CT can be 95% sensitive with contrast and 85% without contrast.

MRI: Finding are characteristic of extraaxial masses: 1. CSF/vascular cleft

betweeen the mass and brain (figure 1) 2. displacement of gray-white matter
interface around mass.

T1 - iso or slightly hypointense relative to cortex