Case report
Perfusion MR imaging and 1H spectroscopy: Their role in the diagnosis of microcystic and lipomatous meningiomasContribution de la perfusion premier passage et de la spectroscopie 1H pour le diagnostic des méningiomes microkystique et lipomateux

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Summary

Microcystic and lipomatous meningiomas represent two of the recognised rare subtypes of meningiomas. We describe the CT and MR findings in one adult case of each subtype with emphasis on the diagnostic benefits of perfusion-weighted MR imaging (PWI) and/or proton magnetic resonance spectroscopy (MRS).

Section snippets

Case 1

A 48-year-old woman presented with a 6-month history of worsening headaches on a background of chronic headaches over several years. Computerised tomography (CT) showed a right-sided, hypo-dense parietal mass (Fig. 1A). The MR study demonstrated an extra-axial lesion that appeared hyper-intense on T2-weighted imaging (Fig. 1B) and hypo-intense on T1-weighted imaging with slight enhancement after Gadolinium (Fig. 1C). Pleating of the adjacent cortex with extension to the calvarium and

Discussion

Meningiomas are classified according to 15 subtypes [1] (WHO classification) and may have atypical features on both CT and MRI studies.

Conclusion

These two cases of meningioma demonstrate the utility of PWI and 1H spectroscopy in the diagnosis of two rare histological variants; the microcystic and lipomatous forms of this intracranial neoplasm.

Conflicts of interests

None.

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    • <sup>1</sup>H-MRS of intracranial meningiomas: What it can add to known clinical and MRI predictors of the histopathological and biological characteristics of the tumor?

      2011, Clinical Neurology and Neurosurgery
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      Therefore, it can be speculated, that combined use of various neuroimaging modalities including 1H-MRS may provide an opportunity for non-invasive identification of angiomatous meningiomas, which might have some clinical implications due to their prominent vascularization. On the other hand spectroscopic imaging can be possibly helpful in detection of rare lipomatous meningiomas [28,42], which are characterized by metaplastic transformation of the tumor cells into adipocytes, but no one such case was present in our series. Low signal intensity of meningioma on T2-weighted images correlates with predominance of fibrous components, relative increase of collagen content, and the presence of calcifications [61,63,67].

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