Three cases of sporadic meningioangiomatosis with different imaging appearances: case report and review of the literature

Abstract

BackgroundMeningioangiomatosis (MA) is a rare meningiovascular malformation or hamartomatous lesion in the central nervous system. Radiographic findings of MA may show a variety of characteristics according to different histological components. We present three cases of sporadic MA with different imaging appearances in an attempt to identify specific imaging characteristics.Case presentationIn case 1, an irregular hyperdense solid mass was localized in the left middle cranial fossa, demonstrating low and equal signal intensity on T1-weighted imaging (T1WI; TR/TE 2,048.9 ms/26.1 ms), high signal intensity with multiple flow void effect on T2-weighted imaging (T2WI; TR/TE 4,000 ms/106.4 ms), and significant and homogeneous enhancement on post-contrast magnetic resonance imaging (MRI). In case 2, the lesion in the right insular lobe showed a cystic-mural nodule pattern. The cystic content demonstrated similar density or signal intensity as cerebrospinal fluid, while the mural nodule demonstrated equal density or signal intensity on computed tomography (CT) and MRI. On post-contrast MRI, the mural nodule showed significant enhancement, but the cystic wall and content showed no enhancement. In case 3, a remarkably enhanced solid nodule was found in the cortex of the left parietal lobe with multiple small cysts surrounding it. This nodule showed low signal intensity on T2WI and diffusion-weighted imaging (DWI; TR/TE 6,000 ms/96.8 ms, b = 1,000 s/mm2). The preoperative diagnoses of the above three cases were meningioma, hemangioblastoma, and ganglioglioma. However, all were pathologically diagnosed as MA.ConclusionThe presented cases demonstrate that MA may present with solid and cystic imaging patterns, which may include large cystic-mural nodules and small intra- and extra-cystic patterns. Although MA imaging diagnoses are difficult, several MRI signs may include specific characteristics, such as a flow void effect on T2WI and separating cysts in the cystic MA (as shown in our cases), gyriform hyperintensity on T2-fluid attenuated inversion recovery (FLAIR) sequence, and susceptibility artifacts on T2 gradient echo (GRE) sequences (as found in the literature).

Sporadic Meningioangiomatosis: A Series of Three Pediatric Cases

“…As noted, the mean age of presentation for sporadic MA is 18.6 years. However, patients ranged from a second-trimester fetus to a 73-year-old female in our review of the literature [ 8 - 9 ]. Therefore, MA may be considered in cases of refractory seizures in all age groups.…”

Meningioangiomatosis: Clinical, Imaging, and Histopathologic Characteristics

“…Meningioangiomatosis is a rare hamartomatous or meningiovascular lesion involving the central nervous system. [1] ere is often a predilection for the frontal and temporal lobes. [2] e most common clinical presentation is headache and seizures.…”

“…[2] e most common clinical presentation is headache and seizures. [1,2] Radiographic findings of meningioangiomatosis are variable depending on the histologic components of the mass. [1] Meningioangiomatosis is typically cortical based and can present as a solitary or multiple lesions.…”

“…[1,2] Radiographic findings of meningioangiomatosis are variable depending on the histologic components of the mass. [1] Meningioangiomatosis is typically cortical based and can present as a solitary or multiple lesions. It demonstrates variable degrees of calcification, cystic degeneration, and enhancement.…”

COMPARISON BETWEEN THE CT & MRI FOR MENINGIOMA IN THE BRAIN IN KING KHALID UNIVERSITY HOSPITAL RIYADH K.S.A.

“…The contrast-enhanced studies proved to be superior to the plain CT and MRI studies as regards image contrast and tumor delineation. Because of the methodological advantages of the MRI technique, contrastenhanced MRI was judged to be slightly superior to contrast-enhanced CT. (2) Magnetic resonance imaging (MRI) with gadolinium contrast enhancement in defining the histologic margins of brain tumors (14) . compared to conventional computed tomography (CT) using iodinated contrast enhancement.…”