Intracranial grade I meningiomas: Confrontation between histological examination and magnetic resonance imaging

##plugins.themes.academic_pro.article.main##

Alia Zehani
Yoldez Houcine
Ines Chelly
Aymen Arous
Cyrine Drissi
Slim Haouet
Nidhameddine Kchir

Abstract

Introduction: Meningiomas are tumors derived from arachnoid cells. More than 90% of cases have a benign clinical course and are classified as grade I according to the World Health Organization. A confrontation between radiologic findings and pathological examination is necessary to predict the grading of meningiomas.
Objectives: To study the radiological presentation by magnetic resonance imaging (MRI) and pathological features of intracranial meningiomas grade I.
Methods: This was a retrospective descriptive study of a series of 35 cases of grade I meningiomas. A review of MRI images was performed in this study.
Results: Our series consisted of 25 female and 10 male patients with a mean age of 49.2 years.The tumor was localized at the base of the skull in 20 cases (57.14%). The average size was 49 mm. At MRI, all meningiomas were solid showing enhancement after injection of contrast agent. This enhancement was homogeneous in 21 cases and heterogeneous in 14 cases. The edema was broad and extended in 15 cases, reduced in 8 cases and absent in 12 cases. The mean minimum apparent diffusion coefficient was 0.77 and the mean maximum average diffusion coefficient was 0,8. On histological examination, the meningioma was of meningotheliomatous type in 23 cases (65.7%), fibroblastic in 8 cases (22.9%), transitional 3 cases (8.6%) and angiomatous in one case (2,8%).
Conclusion: Although the final diagnosis of meningioma is mainly based on pathological examination, comparison with imaging is also important to orient the pathologist.

Keywords:

meningioma; magnetic resonance imaging; pathology

##plugins.themes.academic_pro.article.details##

References

  1. Martin N, Mokhtari K. Les tumeurs intracrâniennes. Sauramps médicale ; 2009. p 377-411.
  2. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Ellision DW, Figarella-Branger D, Reifenberger G, von Deimling A. World Health Organisation classification of tumours of the Central Nervous System. Lyon: IARC Press; 2016. p.163.
  3. Lamszus K. Meningioma Pathology, Genetics, and Biology. J Neuropathol Exp Neurol 2004;63:275-86.
  4. Megdiche-Bazarbacha H, Ben-Yahmed A, Sebai R, Mahjoubi I, Touibi S. Méningiome de l'enfant : un nouveau cas sans attache durale. J Pédiat 2005;18:55-8.
  5. Jaaskelainen J, Haltia M, Servo A. Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy, and outcome. Surg Neurol 1986; 25: 233-42.
  6. Mahmood A1, Caccamo DV, Tomecek FJ, Malik GM. Atypical and malignant meningiomas: a clinicopathological review. Neurosurgery 1993; 33: 955-63.
  7. Hug EB, Devries A, Thornton AF, et al. Management of atypical and malignant meningiomas: role of high-dose, 3D-conformal radiation therapy. J Neurooncol 2000;48:151-60 .
  8. Modha A, Gutin PH. Diagnosis and treatment of atypical and anaplastic meningiomas: a review. Neurosurgery 2005; 57: 538-50.
  9. Delmaire C, Gauvrit JY, Hajj EL, Soto Ares G, Ayachi M, Reyns N et al. Tumeurs cranio-encéphaliques de la ligne médiane. J Radiol 2006;87:764-78.
  10. Bing F, Salon C, Bessou P, Krainik A, Le Bas JF, Grand S. Pathologie tumorale des meningiomes intracraniens. J Radiol 2009 ; 90: 124.
  11. Winther TL, Torp SH. The significance of the extent of resection in modern neurosurgical practice of WHO grade I meningiomas. World Neurosurg 2017;99:104-10.
  12. Schob S, Frydrychowicz C, Gawlitza M, Bure L, Preuß M, Hoffmann KT, et al. Signal Intensities in Preoperative MRI Do Not Reflect Proliferative Activity in Meningioma. Transl Oncol 2016;9:274-9.
  13. Gawlitza M, Fiedler E, Schob S, Hoffmann KT, Surov A. Peritumoral Brain Edema in Meningiomas Depends on Aquaporin-4 Expression and Not on Tumor Grade, Tumor Volume, Cell Count, or Ki-67 Labeling Index. Mol Imaging Biol 2017;19:298-304.
  14. Gawlitza M, Fiedler E, Schob S, Hoffmann KT, Surov A. Peritumoral Brain Edema in Meningiomas Depends on Aquaporin-4 Expression and Not on Tumor Grade, Tumor Volume, Cell Count, or Ki-67 Labeling Index. Mol Imaging Biol 2017;19:298-304.
  15. Grand S, Lefournier V, Krainik A, et al. Imagerie de perfusion : principes et applications cliniques. J Radiol 2007; 88:444-71.
  16. Grand S, Lefournier V, Krainik A, Bessou P, Tropres I, Chabardes S et al. Imagerie de perfusion : principes et applications cliniques. J Radiol 2007; 88:444-71.
  17. Gallagher MJ, Jenkinson MD, Brodbelt AR, Mills SJ, Chavredakis E. WHO grade 1 meningioma recurrence: Are location and Simpson grade still relevant? Clin Neurol Neurosurg 2016;141:117-21.
  18. Hamon M, Coskun O, Courthéoux P, Théron J, Leclerc X. IRM de diffusion du système nerveux central : applications cliniques. J Radiol 2005;86:369-85.
  19. Souei Mhiri M, Ben Rhouma K, Tlili-Graiess K, et al. Aspects en imagerie par résonance magnétique des méningiomes kystiques à propos de 4 cas. J Neuroradiol 2005;32:54-8.
  20. Grand S, Tropres I, Krainik A, Kremer S, Hoffmann D, Berger F et al. Apports des nouvelles techniques d'imagerie au diagnostic des tumeurs cérébrales sus tentorielles de l'adulte. Encycl Méd chir 2006,31-657-D-10.
  21. Combaz X, Girarda N, Scavarda D, et al. Imaging of brain tumors in children. J Neuroradiol 2008; 35:261-7.
  22. Lin Z, Zhao M, Ren X, et al. Clinical features, radiological findings, and surgical outcomes of 65 intracranial psammomatous meningiomas. World Neurosurg 2017;100:395-406.