Magnetic Resonance Imaging Patterns of Intracranial Meningiomas in Erbil City

Abstract

Background and objectives: Meningiomas are the most common non-glial tumors of the central nervous system representing around one fifth of primary intracranial tumors with annual incidence of six per 100,000 populations. This study aimed to address the diagnostic precision of magnetic resonance imaging as a brain investigation tool to evaluate meningioma diagnosis and tumor staging before performing the operation. Methods: This study designed as a cross-sectional study and carried out between December 2019 and December 2020. A total number of 48 meningiomas resected and evaluated at three public hospitals in Erbil City. Pre-operative magnetic resonance imaging investigation and postoperative histopathological evaluation were done for all patients for their intracranial tumors and tissue sections. Results: Majority of patients showed isointense pattern on T1 (87.5%) and T2 (85.4%) signal intensity, homogenous in consistency (81.3%), the vast majority of the meningiomas were typical (93.8%) and of meningothelial type (81.3%). In most of the cases, there was no bone involvement (77.1%), no invasion of dural venous sinuses (83.3%), no calcifications (83.3%), no cystic changes (97.9%) but positive cerebral spinal fluid cleft (66.7%) and homogenous enhancement pattern (83.3%). Five out of eleven imaging patterns and configurations including T1 signal intensity, T2 signal intensity, consistency, calcification and vascularity of the meningioma were valid and reliable by calculating their sensitivity, specificity and running kappa test. Conclusions: Some magnetic resonance imaging patterns such as T1 signal intensity, T2 signal intensity, consistency, calcification, and vascularity of the meningioma are useful for predicting the stages of meningioma.