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Differentiating microcystic meningioma from atypical meningioma using diffusion-weighted imaging

  • Diagnostic Neuroradiology
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Abstract

Purpose

Microcystic meningioma (MCM) appears similar to atypical meningioma(AM) as per conventional diagnostic imaging. However, considering their different recurrence rate and prognosis, accurate differential diagnosis is essential for determine the appropriate treatment strategy. The aim of the study was to differentiate MCM from AM by diffusion-weighted imaging (DWI), in order to provide the basis for accurate preoperative diagnosis.

Methods

The preoperative clinical data, conventional MRI and DWI data of 15 MCM and 30 AM cases were retrospectively analyzed. The average apparent diffusion coefficient (ADCmean), minimum ADC (ADCmin) and normalized ADC (nADC) between MCM and AM were compared using two sample t-tests. The value of ADCmean, ADCmin and nADC in the differential diagnosis of MCM and AM were calculated by the receiver operating curve (ROC) analysis.

Results

The ADCmean (1.06 ± 0.10 vs 0.80 ± 0.11 × 10−3 mm2/s; P < 0.001), ADCmin (0.99 ± 0.10 vs 0.74 ± 0.12 × 10−3 mm2/s; P < 0.001) and nADC (1.45 ± 0.17 vs 1.07 ± 0.17; P < .0001) were significantly higher in MCM compared to AM. ADCmean of 0.91 × 10−3 mm2/s showed an optimum area under the ROC curve of 0.967 ± 0.022, and distinguished between MCM and AM with 86.67% sensitivity, 100% specificity and 88.89% accuracy. In addition, its positive and negative predictive values were 96.29% and 77.78% respectively.

Conclusions

DWI can differentially diagnose MCM and AM, and ADCmean is a potential quantitative tool that can improve preoperative diagnosis of both tumors.

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Funding

This study was funded by the Health Industry Research Program Funding Project of Gansu Province (No.GSWSKY2018–52).

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Authors and Affiliations

  1. Department of Radiology, Lanzhou University Second Hospital, Second Clinical School, Lanzhou University, Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, 730030, China

    Ke Xiaoai, Zhou Qing, Han Lei & Zhou Junlin

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  1. Ke Xiaoai
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Correspondence to Zhou Junlin.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Xiaoai, K., Qing, Z., Lei, H. et al. Differentiating microcystic meningioma from atypical meningioma using diffusion-weighted imaging. Neuroradiology 62, 601–607 (2020). https://doi.org/10.1007/s00234-020-02374-3

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