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Role of diffusion-weighted imaging in differentiating angiomatous meningioma from atypical meningioma



Background:

Conventional magnetic resonance imaging (MRI) characteristics of angiomatous meningioma (AM) and atypical meningioma (ATM) sometimes overlap. However, there are significant differences in the treatment and prognosis of the two tumors. The aim of the study was to assess the role of diffusion-weighted imaging (DWI) in differentiating AM from ATM.


Methods:

Clinical, MRI, and pathological data of 25 patients with AM and 30 patients with ATM were retrospectively analyzed. Main clinical indexes, conventional MRI characteristics, and apparent diffusion coefficient (ADC) values were compared between the two groups, and receiver operating characteristic (ROC) curves were drawn to determine the diagnostic performance of ADC values in distinguishing AM from ATM.


Results:

The minimum ADC value (ADCmin), average ADC value (ADCmean), and relative ADC value (rADC) for AM (908.00 ± 117.00 × 10-6 mm2/s, 921.04 ± 67.09 × 10-6 mm2/s, and 1.15 ± 0.09, respectively) were significantly higher than those for ATM (710.50 ± 79.80 × 10-6 mm2/s, 748.50 ± 67.27 × 10-6 mm2/s, and 0.96 ± 0.09, respectively; all P < 0.05). ROC analysis showed that ADCmin had the best diagnostic performance in distinguishing AM from ATM, with an area under the curve value of 0.977. When using 759.00 × 10-6 mm2/s as the optimal threshold, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 90.00 %, 96.00 %, 92.72 %, 96.40 %, and 88.90 %, respectively.


Conclusions:

DWI plays an important role in differentiating AM from ATM, and ADCmin is the most promising potential parameter that can improve the preoperative diagnostic accuracy of both tumors.


Keywords:

Angiomatous meningioma; Apparent diffusion coefficient; Atypical meningioma; Diffusion-weighted imaging.



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