NeuroradiologyEn plaque meningioma
meningioma which grows in a flattened, "carpet-like" fashion along the dural structures. They frequently infiltrate into and through the dura (for example through falx and tentorium). They can invade the adjacent bone causing hyperostosis.
On MR they appear as sessile dural thickenings, with marked contrast enhancement, that can be focal or diffuse (Fig.1). Similar imaging appearances can be seen with carcinomatous meningitis, infectious and granulomatous meningitis, idiopathic hypertrophic cranial pachymeningitis, extramedullary haematopoiesis, postcraniotomy meningeal enhancement and meningeal fibrosis following subarachnoid haemorrhage. All these conditions can be indistinguishable from en plaque meningioma unless the precise clinical picture is known.
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a. Axial CT without contrast. Marked hyperostosis of the frontal bone, bilaterally, mainly on the right side, involving the three tables, particularly the outer table.
b, c. MR, T1-weighted images without (b) and with (c) contrast enhancement. The tumour is flat in the intracranial component and isointense. The extracranial component has an hyperintense fatty degeneration . Marked homogeneous enhancement of the intracranial component (c).
d, e. MR, T1-weighted sagittal images, without (d) and with (e) contrast enhancement. The precise topography and extent of both intra- and extracranial components are well appreciated.
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En plaque meningioma, Fig.1 (a) | | En plaque meningioma, Fig.1 (b) | | En plaque meningioma, Fig.1 (c) |
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En plaque meningioma, Fig.1 (d) | | En plaque meningioma, Fig.1 (e) | |