Abstract
The purpose of this study was to relate the pathological and imaging features of dural enhancement and meningeal sign (“dural tail”) on contrast-enhanced T1-weighted magnetic resonance (MR) images from patients with primary calvarial lesions as well to assess the accuracy of MR imaging in predicting dural invasion. Thirty-two calvarial tumors studied with contrast-enhanced MR imaging and histopathological examination of the dural specimens were reviewed. Sixteen patients presented dural enhancement, eight with tumor invasion. Tumoral invasion of the dura was observed in one case without enhancement. Malignant lesions showed enhanced dura more commonly than benign lesions (P=0.02). Nodular and discontinuous dural enhancement was statistically associated with dural invasion (P=0.05). Dural tail did not show a specific pathological association. Meningeal enhancement is a nonspecific reaction to calvarial lesions unless nodular and discontinuous. False-negative and -positive cases of dural invasion imply some limitation of contrast-enhanced MR imaging in predicting dural invasion by calvarial neoplasms.
Similar content being viewed by others
References
Ahmadi J, Hinton DR, Segall HD, Couldwell WT (1994) Surgical implications of magnetic resonance-enhanced dura. Neurosurgery 35:370–377
Eisen M, Yousem D, Montone K, Kotapka M, Bigelow D, Bilker W, Loevner L (1996) Use of preoperative MR to predict dural, perineural, and venous sinus invasion of skull base tumors. AJNR Am J Neuroradiol 17:1937–1945
Arana E, Martí-Bonmatí L (1999) CT and MR imaging of focal calvarial lesions. AJR Am J Roentgenol 172:1683–1688
Okamoto K, Ito J, Furusawa T, Sakai K, Tokiguchi S (1999) Imaging of calvarial eosinophil granuloma. Neuroradiology 41:723–728
Wilms G, Lammens M, Marchal G, Demaerel P, Verplancke J, Van Calenbergh F (1991) Prominent dural enhancement adjacent to nonmeningiomatous malignant lesions on contrast-enhanced MR images. AJNR Am J Neuroradiol 12:761–764
Meltzer C, Smirniotopoulos J, Fukui M (1998) The dural tail. Int J Neuroradiol 4:33–40
Goldsher D, Litt A, Pinto R, Bannon K, Kricheff I (1990) Dural “tail” associated with meningiomas on Gd-DPTA-enhanced MR images: characteristics, differential diagnostic value, and possible implications for treatment. Radiology 176:447–450
Meltzer C, Fukui M, Kanal E, Smirniotopoulos J (1996) MR imaging of the meninges. Part I. Normal anatomic features and noneoplastic disease. Radiology 201:297–308
Ruff RJ, Osborn AG, Harnsberger HR, Kubal WS (1985) Extracalvarial soft tissues in cranial computed tomography. Normal anatomy and pathology. Invest Radiol 20:374–380
Van Tuyk R, Gussack G (1991) Prognostic factors in craniofacial surgery. Laryngoscope 101:240–244
West MS, Russell EJ, Breit R, Sze G, Kim KS (1990) Calvarial and skull base metastases: comparison of nonenhanced and Gd-DTPA-enhanced MR images. Radiology 174:85–91
Ahmadi J, Hinton DR, Segall HD, Couldwell WT, Stanley RB (1993) Dural invasion by craniofacial and calvarial neoplasms: MR imaging and histopathologic evaluation. Radiology 188:747–749
Hiramatsu K, Miyazawa T, Suzuki K, Ishihara S, Nakau H, Shima K, Aida S, Tamai S, Chigasaki H (1995) [Calvarial metastasis of cervical carcinoma showing the dural tail sign on magnetic resonance imaging] . No To Shinkei 45:37–63
Vogl TJ, Dresel S, Bilaniuk L, Grevers G, Kang K, Lissner J (1990) Tumors of the nasopharynx and adjacent areas: MR imaging with Gd-DPTA. AJNR Am J Neuroradiol 11:187–194
Anegawa S, Hayashi T, Torigoe R, Furukawa Y (1999) Diffuse calvarial meningioma. Case report and review of the literature. J Neurosurg 90:970–973
Nägele T, Petersen D, Klose U, Grodd W, Opitz H, Voigt K (1994) The dural tail adjacent to meningiomas studied by dynamic contrast-enhanced MRI. A comparison with histopathology. Neuroradiology 36:303–307
Kawahara Y, Niiro M, Yokoyama S, Kuratsu J (2001) Dural congestion accompanying meningioma invasion into vessels: the dural tail sign. Neuroradiology 43:462–465
Hodges F (1989) Pathology of the skull. In: Taveras J, Ferruci J (eds) Radiology diagnosis imaging intervention. J.B. Lippincott Company, Philadelphia, pp 1–21
Peterson DL, Murk SE, Story JL (1992) Multifocal cavernous hemangioma of the skull: report of a case and review of the literature. Neurosurgery 30:778–781
Cervoni L, Artico M, Delfini R (1995) Intraosseous cavernous hemangioma of the skull. Neurosurg Rev 18:61–64
Burger PC, Vogel FS (1982) The intracranial meninges. In: Burger PC, Vogel FS (eds) Surgical pathology of the nervous system and its coverings. Wiley, New York, pp 83–169
Ruge JR, Tomita T, Naidich TP, Hahn YS, McLone DG (1988) Scalp and calvarial masses of infants and children. Neurosurgery 22:1037–1042
Hutzelmann A, Palmié S, Buhl R, Freund M, Heller M (1998) Dural invasion of meningiomas adjacent to the tumor margin on Gd-DPTA-enhanced MR images: histopathologic correlation. Eur Radiol 8:746–748
Nakau H, Miyazawa T, Tamai S, Tsuchiya K, Shima K, Shirotani T, Chigasaki H (1997) Pathologic significance of meningeal enhancement (“flare sign”) of meningiomas on MRI. Surg Neurol 48:584–591
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Arana, E., Martí-Bonmatí, L., Ricart, V. et al. Dural enhancement with primary calvarial lesions. Neuroradiology 46, 900–905 (2004). https://doi.org/10.1007/s00234-004-1284-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00234-004-1284-1