MR diffusion and dynamic-contrast enhanced imaging to distinguish meningioma, paraganglioma, and schwannoma in the cerebellopontine angle and jugular foramen.

Abstract

Differentiation ofmeningiomas, paragangliomas, and schwannomasin the cerebellopontine angle and jugular foramen remainschallengingwhen conventional MRI findings are inconclusive.This study aimed to assess the clinical utility of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) findings for tumor type differentiation and to identify the most significant diagnostic parameters. This retrospective study included 57 patients with pathologically confirmedmeningiomas, paragangliomas, and schwannomas, diagnosedbetweenJanuary 2018 and August 2021. DWI and DCE-MRI were obtained before surgery. The apparent diffusion coefficient (ADC)and DCE-MRI parameterswere calculated. The Kruskal-Wallis H test and post hoc test with Bonferroni correction and receiver operating characteristic curve were used for statistical analysis. There were 20 meningiomas (6 men; 62.3±17.8 years), 23 paragangliomas (3 men; 51.6±17.0 years), and 14 schwannomas (7 men; 37.7±20.0 years). Vp showed a significant difference in each comparison (p < .001, <.001, and <.001, respectively), Ve showed significant differences both in meningiomas and paragangliomas, and paragangliomas and schwannomas (p < .001 and .017, respectively), and Ktrans showed significant differences both in meningiomas and paragangliomas, and meningiomas and schwannomas (p = .0018 and <.001, respectively), though there was no significant difference in ADC. Vp diagnostic performance values for each pair of tumors were area under the curve of 0.89-1.00, with cutoff values of 0.14-0.27. DCE-MRI can provide promising parameters to differentiate meningiomas, paragangliomas, and schwannomas in the cerebellopontine angle and jugular foramen.