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Research ArticleAdult Brain

Is Contrast Medium Really Needed for Follow-up MRI of Untreated Intracranial Meningiomas?

J. Boto, R. Guatta, A. Fitsiori, J. Hofmeister, T.R. Meling and M.I. Vargas
American Journal of Neuroradiology August 2021, 42 (8) 1421-1428; DOI: https://doi.org/10.3174/ajnr.A7170
J. Boto
aFrom the Division of Neuroradiology (J.B., A.F., M.I.V.), Geneva University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
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R. Guatta
bDivision of Neurosurgery (R.G., T.R.M.), Lugano Regional Hospital (Civic), Lugano, Switzerland
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A. Fitsiori
aFrom the Division of Neuroradiology (J.B., A.F., M.I.V.), Geneva University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
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J. Hofmeister
cDivision of Radiology (J.H.), Geneva University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland.
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T.R. Meling
bDivision of Neurosurgery (R.G., T.R.M.), Lugano Regional Hospital (Civic), Lugano, Switzerland
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M.I. Vargas
aFrom the Division of Neuroradiology (J.B., A.F., M.I.V.), Geneva University Hospital and Faculty of Medicine of Geneva, Geneva, Switzerland
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Figures

  • FIG 1.
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    FIG 1.

    Flow diagram showing the steps in patient selection. NF2 indicates neurofibromatosis type 2.

  • FIG 2.
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    FIG 2.

    A 41-year-old man with a meningioma of the right convexity adjacent to the parietal lobe. Segmentation of the meningioma is achieved by shading the lesion in blue using a semi-automated software (A–C). The voxels outside the shaded volume can be discarded, and the voxels within the volume (shown as 3D-rendering in D, E, and F) can be isolated and exported to the PACS or any other software for further analysis.

  • FIG 3.
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    FIG 3.

    Chart showing the number of included intracranial meningiomas by sex and specific location. Cerebral convexity parasagittal, falcine, intraventricular, and cerebellar convexity meningiomas are considered non-skull base. All other locations are considered skull base. Post. indicates posterior.

  • FIG 4.
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    FIG 4.

    Same patient as in Fig 2 with a meningioma of the right convexity adjacent to the parietal lobe. Axial (A), coronal (C) and sagittal (D) THRIVE Gd and axial T2-weighted (E) images depict a meningioma of the right convexity exerting mass effect on the adjacent brain parenchyma of the parietal lobe (arrow, A, C, D, and E). Axial THRIVE Gd (B) and T2-weighted (F) images of the isolated lesion obtained with the semi-automated software, from which 3D-rendering can easily be performed with any DICOM viewer (G, THRIVE Gd. H, T2WI).

  • FIG 5.
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    FIG 5.

    A 52-year-old woman. Axial (A), coronal (C) and sagittal (D) THRIVE Gd and axial T2-weighted (E) images show a meningioma arising from the planum sphenoidale and orbital roof on the right (white arrow, A, C, D, and E). The lesion crosses the midline and is in close contact with the cisternal segment of the right optic nerve (white arrowhead in D), the supraclinoid right internal carotid artery (black arrow, C), and cranial aspect of the right cavernous sinus (black arrowhead, C). Axial THRIVE Gd (B) and T2-weighted (F) images of the isolated lesion obtained with the semi-automated software, from which 3D-rendering was performed with our DICOM viewer (G, T1 3D-fat-saturated Gd; H, T2WI). This case illustrates a particularly challenging meningioma for which the skull base location, close contact with other structures, and irregular shape made the segmentation process more difficult.

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American Journal of Neuroradiology: 42 (8)
American Journal of Neuroradiology
Vol. 42, Issue 8
1 Aug 2021
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Cite this article
J. Boto, R. Guatta, A. Fitsiori, J. Hofmeister, T.R. Meling, M.I. Vargas
Is Contrast Medium Really Needed for Follow-up MRI of Untreated Intracranial Meningiomas?
American Journal of Neuroradiology Aug 2021, 42 (8) 1421-1428; DOI: 10.3174/ajnr.A7170

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Is Contrast Medium Really Needed for Follow-up MRI of Untreated Intracranial Meningiomas?
J. Boto, R. Guatta, A. Fitsiori, J. Hofmeister, T.R. Meling, M.I. Vargas
American Journal of Neuroradiology Aug 2021, 42 (8) 1421-1428; DOI: 10.3174/ajnr.A7170
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