الفهرس 
Anatomy of the MeningesOnly 14 pages are availabe for public view
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Abstract
Background: Meningiomas are the most frequent primary central nervous system (CNS) neoplasms in adults, accounting for 24-30% of primary intracranial tumors and develop from arachnoid meningothelial cells. Their incidence increases with aging with a mean age of 65 years at diagnosis and with a significant female predominance.
Objective: to evaluate the usefulness of a comprehensive multi-parametric MRI approach that includes morphological features, quantitative diffusion metrics and semi-quantitative SWI parameters in the pre-operative grading of meningiomas.
Patients and Methods: This cross-sectional study was conducted on 36 adult participants recruited from the neurosurgery outclinics of Ain Shams University. The procedures were performed at the MRI unit, Radiology department, Ain Shams University hospitals. The study period was 12 months.
Results: A total of 36 patients were recruited and underwent routine MRI of the brain, followed by DWI and SWI. Among different morphological features of both low and high-grade meningiomas, larger tumor size, unclear TBI, lobulated tumor margins, heterogenous contrast enhancement, midline line shift, and intratumoral cysts were significantly higher in high-grade meningiomas. Low-grade meningiomas had considerably higher Mean ADC value in the tumor and nADC (ratio between tumor and normal side in ADC) with sensitivity of the mean ADC in the tumor (85.71%), specificity (93.10%) while sensitivity of the n ADC was (85.71%) and specificity was (96.55%) so the ratio increased the diagnostic accuracy from (84%) to (86.7%). ITSSs seen in SWI, showed significant difference between both groups where the most common grade seen in low grade meningiomas was grade 1 and the most common grades seen in high grade meningiomas were grades 2 and 3, seen equally. The sensitivity of SWI to detect high grade tumors was (85.71%), specificity was (68.97%) and accuracy was (72.22%).
Conclusions: Using a combination of conventional characteristics of the tumor with quantitative DWI and semiquantative assessment of SWI gives more information for non-invasive preoperative pathological grading of meningiomas, hence assisting the surgeon and oncologist in proper treatment planning with tumor size as the strongest predictor of tumor grade among all variables.