TY - JOUR
T1 - Chordoid meningioma
T2 - Differentiating a rare world health organization grade II tumor from other meningioma histologic subtypes using MRI
AU - Pond, X. J B
AU - Morgan, T. G.
AU - Hatanpaa, K. J.
AU - Yetkin, Z. F.
AU - Mickey, B. E.
AU - Mendelsohn, D. B.
N1 - Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - BACKGROUND AND PURPOSE: Meningiomas are very commonly diagnosed intracranial primary neoplasms, of which the chordoid subtype is seldom encountered. Our aim was to retrospectively review preoperative MR imaging of intracranial chordoid meningiomas, a rare WHO grade II variant, in an effort to determine if there exist distinguishing MR imaging characteristics that can aid in differentiating this atypical variety from other meningioma subtypes. MATERIALS AND METHODS: Ten cases of WHO grade II chordoid meningioma were diagnosed at our institution over an 11-year span, 8 of which had preoperative MR imaging available for review and were included in our analysis. Chordoid meningioma MR imaging characteristics, including ADC values and normalized ADC ratios, were compared with those of 80 consecutive cases of WHO grade I meningioma, 21 consecutive cases of nonchordoid WHO grade II meningioma, and 1 case of WHO grade III meningioma. RESULTS: Preoperative MR imaging revealed no significant differences in size, location, signal characteristics, or contrast enhancement between chordoid meningiomas and other meningiomas. There were, however, clear differences in the ADC values and normalized ADC ratios, with a mean absolute ADC value of 1.62 ± 0.33 × 10-3 mm2/s and a mean normalized ADC ratio of 2.22 ± 0.47 × 10-3 mm2/s in chordoid meningiomas compared with mean ADC and normalized ADC values, respectively, of 0.88±0.13×10-3mm2/s and 1.17±0.16× 10-3 mm2/s in benign WHO grade I meningiomas, 0.84 × 0.11 × 10-3 mm2/s and 1.11 ± 0.15 × 10-3 mm2/s in nonchordoid WHO grade II meningiomas, and 0.57 × 10-3 mm2/s and 0.75 × 10-3 mm2/s in the 1 WHO grade III meningioma. CONCLUSIONS: Chordoid meningiomas have statistically significant elevations of ADC and normalized ADC values when compared with all other WHO grade I, II, and III subtypes, which enables reliable preoperative prediction of this atypical histopathologic diagnosis.
AB - BACKGROUND AND PURPOSE: Meningiomas are very commonly diagnosed intracranial primary neoplasms, of which the chordoid subtype is seldom encountered. Our aim was to retrospectively review preoperative MR imaging of intracranial chordoid meningiomas, a rare WHO grade II variant, in an effort to determine if there exist distinguishing MR imaging characteristics that can aid in differentiating this atypical variety from other meningioma subtypes. MATERIALS AND METHODS: Ten cases of WHO grade II chordoid meningioma were diagnosed at our institution over an 11-year span, 8 of which had preoperative MR imaging available for review and were included in our analysis. Chordoid meningioma MR imaging characteristics, including ADC values and normalized ADC ratios, were compared with those of 80 consecutive cases of WHO grade I meningioma, 21 consecutive cases of nonchordoid WHO grade II meningioma, and 1 case of WHO grade III meningioma. RESULTS: Preoperative MR imaging revealed no significant differences in size, location, signal characteristics, or contrast enhancement between chordoid meningiomas and other meningiomas. There were, however, clear differences in the ADC values and normalized ADC ratios, with a mean absolute ADC value of 1.62 ± 0.33 × 10-3 mm2/s and a mean normalized ADC ratio of 2.22 ± 0.47 × 10-3 mm2/s in chordoid meningiomas compared with mean ADC and normalized ADC values, respectively, of 0.88±0.13×10-3mm2/s and 1.17±0.16× 10-3 mm2/s in benign WHO grade I meningiomas, 0.84 × 0.11 × 10-3 mm2/s and 1.11 ± 0.15 × 10-3 mm2/s in nonchordoid WHO grade II meningiomas, and 0.57 × 10-3 mm2/s and 0.75 × 10-3 mm2/s in the 1 WHO grade III meningioma. CONCLUSIONS: Chordoid meningiomas have statistically significant elevations of ADC and normalized ADC values when compared with all other WHO grade I, II, and III subtypes, which enables reliable preoperative prediction of this atypical histopathologic diagnosis.
UR - http://www.scopus.com/inward/record.url?scp=84937426947&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84937426947&partnerID=8YFLogxK
U2 - 10.3174/ajnr.A4309
DO - 10.3174/ajnr.A4309
M3 - Article
C2 - 25882286
AN - SCOPUS:84937426947
SN - 0195-6108
VL - 36
SP - 1253
EP - 1258
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 7
ER -