Extra-axial tumour: meningioma

  • most common are meningioma and schwannoma
  • associated with NF type II.
  • Hormone sens, so can grow during pregnancy.
  • Radiation induced meningioma tends to be multiple
  • Most common location: supratentorial.

Radiographic features

CT

  • commonly iso-hyperdense to underlying brain parenchyma
  • if given contrast, will homogenous enhance
  • pneumosinus dilatans may associated with anterior skull meningioma


Pneumosinus dilatans: enlarged paranasal sinus

MRI

  • CSF cleft sign: non-CSF tumour-brain interface (classically thought as a CSF-tumour interace, but often appears bright in FLAIR)
  • Dural tail sign: thickened dural mater adjacent to the mass
  • Spokewheel vascular appearance
  • T1: iso-hypointense
  • T2: iso-hyperintense
  • T1 C+: being an extra-axial tumour, enhances as it lacks blood-brain barrier.


Typical appearance of meningioma with CSF cleft sign and dural tail sign.

Reference: radiopaedia.org

 

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