Abstract
Objective:To determine the diagnostic accuracy of DWI in differentiating benign and malignant meningiomas keeping histopathology as gold standard.Methods:This was a descriptive analytical study conducted at Radiology Department, DUHS/Dr. Ruth K. M. Pfau Civil Hospital Karachi, from August 2016 to March 2018.It included152 patients clinically suspected of meningioma on conventional neuroimaging. Imaging features of DWI were compared with histopathology findings. The diagnostic accuracy of DWI was calculated in terms of sensitivity, specificity, accuracy, PPV and NPV using histopathology as gold standard.Results:There were 59 male and 93 female patients with mean age of 55.38±9.8 years. Mean duration of sign and symptoms was 5.67±2.57 months. Out of 152 patients, 117(77%) and 35(23%) were differentiated into benign and malignant meningiomas respectively by DWI while 135(88.82%) and17(11.18%) patients were diagnosed respectively on histopathology. The sensitivity, specificity, PPV, NPV and accuracy of DWI of 84.4%, 82.3%, 97.4%, 40%, and 84.2% respectively keeping histopathology as gold standard.Conclusion:DWI features along with calculation of ADC values is a reliable non-invasive technique for differentiating benign and malignant meningiomas. However the low negative predictive value necessitates the use of histopathology.
Highlights
Meningiomas are the most common primary extra-axial non-glial intracranial tumors, comprise approximately 14–20% of all intracranial tumors.[1,2] Meningiomas commonly occur on the brain surface and rarely in the brain ventricles
The diagnostic accuracy of Diffusion weighted MRI for differentiating benign and malignant Meningiomas was calculated in terms of sensitivity, specificity, positive predictive values and negative predictive values keeping histopathology as gold standard
One hundred and fifty two patients were enrolled to determine the diagnostic accuracy of Diffusion Weighted MRI in differentiating benign and malignant meningiomas keeping histopathology as gold standard.There were 59 males and 93 females, aged from 21 to 70 years with mean age of 55.38 ± 9.8 years
Summary
Meningiomas are the most common primary extra-axial non-glial intracranial tumors, comprise approximately 14–20% of all intracranial tumors.[1,2] Meningiomas commonly occur on the brain surface and rarely in the brain ventricles They are seen in middle aged patients showing female predilection with male:female ratio of 1:2.3 Tumors less than 2.5cm are rarely symptomatic whereas, larger tumors show symptoms which worsen with time.[4]. Most of meningiomas are typically benign, slow growing and curable by surgery depending on location.[5] About 10% of meningiomas are atypical or malignant associated with higher morbidity and mortality. They may invade the adjacent bone and brain parenchyma so prone to. This study was conducted to compare diffusion-weighted imaging findings of different meningiomas by using apparent diffusion coefficient (ADC) values for predicting tumor grade into benign and malignant meningiomas
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