• F/54• C/C: Headache

CT

T2WI

FLAIR

T1WI

Enhanced T1WI

Enhanced T1WI

TFCA (arterial phase)

TFCA (venous phase)

• Extra-axial neoplastic lesion– Dural based– Dural tail, CSF cleft, gray matter buck-

ling– Blood supply : Rt. middle meningeal

artery

Differential Diagnosis

1. Meningioma

2. Dural metastasis

Assessment(Review of disease)

Meningioma

• Clinical issues15~20%(brain tumor), 25%(spinal cord tumor)

Middle decade (pick : 45years)

M<F (1:1.5~1:3)

Symptoms: <10%

Grow slowly, compress adjacent structures

Metastases rare (0.1-0.2%, histology, location X )

T1 Iso-,HypointensityT1 contrast enhanced high signal imageT2 Iso-,Hyperintensity CSF “cleft”

“Sunburst”“Mother in law” early comes and late stay

• Treatment

Asymptomatic followed with serial imaging

Surgery– Resection of tumor & involved dura/dural

tail(+tumor-free margins)with duraplasty– Resection of involved or hyperostotic bone– Recurrence: 9%

Radiotherapy

Reference • Diagnostic Neuroradiology

– ANNE G. OSBORN

• Diagnostic Imaging <Brain>– OSBORN

• 진단방사선과학– 한만청 편저

• 신경외과학 3rd edition– 대한신경외과학회