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AJNR - American Journal of Neuroradiology

Published ahead of print on February 26, 2009
doi: 10.3174/ajnr.A1526

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American Journal of Neuroradiology 30:1261-1267, June-July 2009
© 2009 American Society of Neuroradiology

BRAIN

Imaging Features of Meningeal Inflammatory Myofibroblastic Tumor

J.-H. Kim^a, K.-H. Chang^a, D.G. Na^a,c, S.-H. Park^b, E. Kim^a, D.H. Han^e, H.-M. Kwon^d, C.-H. Sohn^a and Y.J. Yim^a

^a Department of Radiology, Seoul National University Hospital, Seoul, Korea
^b Department of Pathology, Seoul National University Hospital, Seoul, Korea
^c Human Medical Imaging and Intervention Center, Seoul, Korea
^d Department of Neurology, Seoul Municipal Boramae Hospital (affiliated with Seoul National University Hospital), Seoul, Korea
^e Department of Radiology, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea

Please address correspondence to Kee-Hyun Chang, MD, PhD, Department of Diagnostic Radiology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110–744, Korea; e-mail: changkh{at}radcom.snu.ac.kr

BACKGROUND AND PURPOSE: Meningeal inflammatory myofibroblastic tumor (IMT) has been rarely reported, and its prognosis is still unclear. Our purpose was to describe the imaging features of patients with meningeal IMT and their results on follow-up studies.

MATERIALS AND METHODS: Twenty-four MR images in 10 consecutive patients with pathologically proved meningeal IMTs were retrospectively evaluated, focusing on the lesion distribution, signal intensity (SI), and contrast-enhancement pattern with a review of the clinical records.

RESULTS: Eight patients with intracranial IMT showed localized (n = 4) or diffuse (n = 4) dural thickening, a single mass (n = 5) or 2 (n = 2) dural-based masses with surrounding edema, dural venous sinus thrombosis (n = 5), and leptomeningeal involvement (n = 5). Extracranial involvement of the mastoid (n = 2) and orbit (n = 2) was also associated. Each of the 2 patients with intraspinal IMT showed a dural-based mass and a segmental dural thickening, respectively. All of the thickened dura showed low SI on T2-weighted images, iso-SI on T1-weighted images, and diffuse contrast enhancement. Variable recurrences with dural-based masses, mastoid involvement, or nasolacrimal duct involvement were observed in all 4 patients with diffuse intracranial IMT, but not in the others.

CONCLUSIONS: Localized or diffuse dural thickening of T2 low SI and diffuse contrast enhancement combined with dural-based masses are a common MR imaging finding of meningeal intracranial IMT. Adjacent leptomeningeal involvement and dural venous sinus thrombosis are frequently associated. The diffuse type has a tendency toward recurrence.