MR diffusion and dynamic‐contrast enhanced imaging to distinguish meningioma, paraganglioma, and schwannoma in the cerebellopontine angle and jugular foramen

Ota, Yoshiaki; Liao, Eric; Capizzano, Arístides A.; Yokota, Hajime; Baba, Akira; Kurokawa, Ryo; Kurokawa, Mariko; Moritani, Toshio; Yoshii, Kengo; Srinivasan, Ashok

doi:10.1111/jon.12959

Cited by 14 publications

(16 citation statements)

References 26 publications

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“…However, this technique has not been often utilized for intracranial extra‐axial tumors 13,14 . Paragangliomas are hypervascular tumors with prominent vascular structures, and prior studies using dynamic contrast‐enhanced perfusion MRI (DCE‐MRI) showed that fractional plasma volume, which represents tumor's microvascularity, was higher in paragangliomas than in schwannomas 12,18 . Our result suggests that CBV and CBF can also be promising parameters to differentiate paragangliomas and schwannomas.…”

Section: Discussionmentioning

confidence: 72%

Intracranial paragangliomas versus schwannomas: Role of dynamic susceptibility contrast perfusion and diffusion MRI

Ota

Liao

Capizzano

et al. 2022

Journal of Neuroimaging

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Background and Purpose: Differentiating paragangliomas from schwannomas and distinguishing sporadic from neurofibromatosis type 2 (NF 2)-related schwannomas is challenging but clinically important. This study aimed to assess the utility of dynamic susceptibility contrast perfusion MRI (DSC-MRI) and diffusion-weighted imaging (DWI) in discriminating infratentorial extra-axial schwannomas from paragangliomas and NF2related schwannomas. Methods: This retrospective study included 41 patients diagnosed with paragangliomas, sporadic schwannomas, and NF2-related schwannomas in the infratentorial extra-axial space between April 2013 and August 2021. All cases had pretreatment DSC-MRI and DWI. Normalized mean apparent diffusion coefficient (nADCmean), normalized relative cerebral blood volume (nrCBV), and normalized relative cerebral blood flow (nrCBF) were compared between paragangliomas and schwannomas and between sporadic and NF2related schwannomas as appropriate.Results: nrCBV and nrCBF were significantly higher in paragangliomas than in sporadic/ NF2-related schwannomas (nrCBV: median 11.5 vs. 1.14/3.74; p < .001 and .004, nrCBF: median 7.43 vs. 1.13/2.85; p < .001 and .007, respectively), while nADCmean were not.The corresponding diagnostic performances were area under the curves (AUCs) of .99/.92 and 1.0/.90 with cutoffs of 2.56/4.22 and 1.94/3.36, respectively. nADCmean were lower, and nrCBV and nrCBF were higher in NF2-related than in sporadic schwannomas (nAD-

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Section: Discussionmentioning

confidence: 72%

Intracranial paragangliomas versus schwannomas: Role of dynamic susceptibility contrast perfusion and diffusion MRI

Ota

Liao

Capizzano

et al. 2022

Journal of Neuroimaging

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“…Breger et al [29] studied the signal intensity value on contrast-enhanced T1-weighted image of benign extra-axial tumors on the brain, the results also show that the signal values on T1W after injection of schwannomas is higher than meningiomas. Research by Ota et al [30] reported that differentiation between meningiomas and schwannomas in the cerebellopontine angle and jugular foramen can be relied on some parameters on dynamic-contrast enhanced imaging (DCE-MRI), with significant differences between these two tumor types for the fractional blood plasma volume (Vp) and extracellular extravascular space (Ktrans) (p < 0.001, <0.001, respectively; and AUC of Vp values > 0.9). The report by Meng et al [31] assessed spinal tumor vascularity on DCE-MRI and showed that it is an accurate technique.…”

Section: Discussionmentioning

confidence: 99%

The value of quantitative magnetic resonance imaging signal intensity in distinguishing between spinal meningiomas and schwannomas

Hung¹,

Dung²,

Huyen³

et al. 2022

Int. J. Med. Sci.

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Background: Prior studies have suggested a number of the subjective visual characteristics that help distinguish between spinal meningiomas and schwannomas on magnetic resonance imaging and computed tomography; however, objective quantification of the signal intensity can be useful information. This study assessed whether quantitative magnetic resonance imaging (MRI) signal intensity (SI) measurements could distinguish intradural-extramedullary schwannomas from meningiomas. Methods: From July 2019 to September 2021, 54 patients with intradural-extramedullary tumors (37 meningiomas and 17 schwannomas) underwent surgery, and tumors were verified pathologically. Defined regions of interest were used to quantify SI values on T1-(T1W) and T2-weighted images (T2W). Receiver operating characteristic curve analysis was used to obtain cutoff values and calculate the area under the curve (AUC), sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV). Results: Both Maximum (T2max) and mean (T2mean) T2W SI values demonstrated outstanding (AUC: 0.91) abilities to differentiate meningiomas from schwannomas with Se, Sp, PPV, and NPV values of 94.6%, 70.6%, 87.5%, and 85.7%, respectively, for T2max and 81.1%, 88.2%, 93.8%, and 68.2% for T2mean. The maximum SI value on contrast-enhanced T1W (T1CEmax) and the T2W tumor: fat SI ratio (rTF) demonstrated acceptable abilities (AUC: 0.73 and 0.79, respectively) to differentiate meningiomas from schwannomas with Se, Sp, PPV, and NPV values of 94.6%, 70.6%, 87.5%, and 85.7%, respectively, for T1CEmax and 81.1%, 88.2%, 93.8%, and 68.2% for rTF. Conclusions: Quantitative SI values (T2max, T2mean, T2min, T1CEmax, rTF) can be used to differentiate intradural-extramedullary schwannomas from meningiomas.

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“…Ota, Y. et al detected that the apparent diffusion coefficient (ADC) and the diffusion-weighted imaging (DWI) were important and useful to differentiate SDH mutation [ 28 , 29 ]. Ktrans as a diagnostic parameter of dynamic contrast-enhanced MRI (DCE-MRI) for PGs [ 30 ] could predict the potential efficacy of radiotherapy for paragangliomas [ 31 ]. Although radiotherapy for JFPs is widely described in the literature, efficacy ought to be verified for a longer period of time [ 18 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Staged Surgery for Intra-Extracranial Communicating Jugular Foramen Paraganglioma: A Case Report and Systematic Review

Yanbing

Zhang

et al. 2022

Brain Sciences

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Staged surgery strategy was preferred for patients with intra-extracranial communicating jugular foramen paraganglioma (IECJFP). A female patient who presented mild tinnitus, headache, and dizziness, together with preoperative related imaging, was diagnosed with a left intra-extracranial communicating jugular foramen lesion in November 2015 and accepted an initial operation for the intracranial tumor by retrosigmoid approach. The pathologic report was paraganglioma. In November 2021, a subtotal resection of the extracranial tumor was conducted for prominent lower cranial nerves (LCNs) deficit and middle ear involvement by infratemporal approach. In patients with IECJFP accompanied by LCNs deficit and middle ear involvement, an initial surgery for extracranial lesion and a second procedure for intracranial tumor were appropriate. However, the first operation for the intracranial lesion was preferred in IECJFP cases without LCNs deficit and middle ear involvement, as it could remove compression to the neurovascular structure and brain stem, clarify a pathological diagnosis, avoid a CSF leak, and prevent a severe neurological disorder from extracranial lesion excision. Subtotal resection of the extracranial tumor would be performed when lesion became larger combined with obvious LCNs disorder and tympanic cavity involvement. Consideration of specific staged surgical strategy for IECJFP in accordance with preoperative LCNs deficit and tympanic cavity involvement could prevent critical postoperative neurological deficit and improve quality of life in the long term.

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MR diffusion and dynamic‐contrast enhanced imaging to distinguish meningioma, paraganglioma, and schwannoma in the cerebellopontine angle and jugular foramen

Cited by 14 publications

References 26 publications

Intracranial paragangliomas versus schwannomas: Role of dynamic susceptibility contrast perfusion and diffusion MRI

Intracranial paragangliomas versus schwannomas: Role of dynamic susceptibility contrast perfusion and diffusion MRI

The value of quantitative magnetic resonance imaging signal intensity in distinguishing between spinal meningiomas and schwannomas

Staged Surgery for Intra-Extracranial Communicating Jugular Foramen Paraganglioma: A Case Report and Systematic Review

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