Intratumoral microhemorrhages on T2*-weighted gradient-echo imaging helps differentiate vestibular schwannomas from meningioma

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dc.contributorThamburaj, K.
dc.contributorRadhakrishnan, V. V.
dc.contributorThomas, B.
dc.contributorNair, S.
dc.contributorMenon, G.
dc.date.accessioned2012-12-04T11:44:25Z
dc.date.available2012-12-04T11:44:25Z
dc.date.issued2008
dc.description.abstractBACKGROUND AND PURPOSE: Vestibular schwannomas (VS may be difficult to differentiate from cerebellopontine angle (CPA) meningiomas. Demonstration of microhemorrhages in VS on T2*-weighted gradient-echo (GRE) sequences may have potential value to differentiate VS from CPA meningiomas.MATERIALS AND METHODS: In this prospective study of 20 patients, MR imaging was performed with T2*-weighted GRE in addition to all basic sequences. Histopathologic examination was performed after surgery. Intratumoral hemosiderin was confirmed by pigment staining.RESULTS: There were 15 patients in the VS group with 16 VS and 5 in the meningioma group with 5 posterior fossa meningiomas. Fourteen of the 16 VS and all 5 meningiomas were treated surgically and were confirmed on histopathologic examination. T2*-weighted GRE identified microhemorrhages on T2*-weighted sequence in 15 (93.75%) of the 16 VS. CT excluded calcification in all VS. T2-weighted turbo spin-echo (TSE) and fluid-attenuated inversion recovery (FLAIR) images recognized microhemorrhages in 2 cases. Pigment staining confirmed hemosiderin in all 14 surgically treated VS, and none of the meningiomas showed microhemorrhages on MR imaging. For the detection of microhemorrhages, T2*-weighted GRE showed a sensitivity of 93.8%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 83.3%. The sensitivity of T2 TSE and FLAIR for microhemorrhage was 12.5%. The Fisher exact test showed a statistically significant difference in the differentiation of VS from meningioma on the basis of detection of microhemorrhages (P < .01).CONCLUSION: Most VS demonstrate microhemorrhages on T2*-weighted GRE. This finding is useful to differentiate VS from CPA, meningiomas. T2*-weighted GRE should be used as a basic sequence to evaluate CPA tumors. Identification of microhemorrhages may have the potential to assess the aggressive biologic behavior of VS.
dc.identifier.citationAMERICAN JOURNAL OF NEURORADIOLOGY. 29; 3; 552-557en_US
dc.identifier.urihttp://dx.doi.org/10.3174/ajnr.A0887
dc.identifier.urihttps://dspace.sctimst.ac.in/handle/123456789/655
dc.publisherAMERICAN JOURNAL OF NEURORADIOLOGY
dc.subjectPathology
dc.titleIntratumoral microhemorrhages on T2*-weighted gradient-echo imaging helps differentiate vestibular schwannomas from meningioma
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