Abstract
Background: Meningiomas, common intracranial tumors originating from meningeal cells, critically impact patient outcomes. Their histologic grade influences recurrence risk and treatment decisions, including radiation therapy. Identifying advanced-grade meningiomas via pre-operative MRI is vital for surgical planning, reducing complications, and guiding adjuvant therapies. Objective: To investigate the correlation between pre-operative MRI features and histopathological grade in supratentorial meningiomas. Methods: This cross-sectional study was conducted from July 2019 to December 2020 at the Department of Neurosurgery of Dhaka Medical College and Hospital. A total of 43 patients with supratentorial meningiomas underwent resection and were analyzed in terms of neuroimaging features of pre-operative MRI. The relationships between MRI features and WHO histopathological grade were analyzed and scored quantitatively. Results: The mean age of the study population was 37±11.86 (SD) years. Male female ratio was 1:2.7. Main clinical presentation was headache (90.7%). The most common location was convexity meningioma (37.2%). Out of all patients, high, grade and low-grade meningioma were diagnosed by MRI, 9 (20.93%) and 34 (79.09%), respectively; on the other hand, high, grade and low-grade meningiomas diagnosed by histopathology 7 (16.3%) and 36 (83.7%) respectively. A positive correlation was found between MRI grading and histopathological grading of supratentorial meningiomas and statistical significance (Spearman rho-0.547, p-value <0.001). A significant association was also observed between MRI grading and histopathological grading of supratentorial meningiomas (p-value 0.002). Unclear tumor brain interface, capsular enhancement, and irregular tumor margin in the MRI were identified factors in predicting advanced histopathological grade of meningiomas as p-values 0.002, 0.008, and 0.001, respectively. Conclusion: This scoring approach may be useful for neurosurgeons ...
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