Because of this, SM may be mistaken preoperatively to be a WHO grade 2 meningioma (G2M). Secretory meningioma (SM) is a rare subtype of World Health Organization (WHO) grade 1 meningioma, associated with significant peritumoral brain edema (PTBE). The authors wish to thank the staff of the Neurosurgical MRI unit. Meningioma extending to both supratentorial and infratentorial compartments had the highest risk of having concomitant perilesional oedema and mass effects. Every additional increase of centimetre of the maximum diameter was associated with 1.5 times increased risk of developing perilesional oedema and over three times increased risk of developing mass effects. The findings of this study suggest that the maximum diameter and the location of the meningioma to be the most effective predictors of peritumoral oedema and mass effect, compared with the side of the tumour located Conclusionīased on our findings, the maximum diameter of meningioma and its location could predict both perilesional oedema and mass effect. Therefore, MRI is used in such cases as the only tool to diagnose meningioma and for the early detection of complications during follow-up. The relatively benign nature of meningioma has led to conservative management specially for the majority of the incidentally detected lesions. Patients with missing data were excluded case-wise in the statistical analyses if at least a single predictor or outcome variable were not reported (size, side, age, sex ). Ninety-one patients had single meningiomas, while nine had multiple meningiomas. The median age was 50 years (IQR = 42–64 years). Of 100 patients, female to male ratio was 5.8:1. The sample size was calculated for binary logistic Results Data were retrieved from the unit database at the neurosurgical MRI unit of the National Hospital of Sri Lanka. This study retrospectively analysed MRI findings and relevant clinical data of 100 consecutive patients who were diagnosed on MRI brain to have meningioma. The study protocol was approved by the Ethics Review Committee, Faculty of Medicine, University of Colombo, Sri Lanka (Reference number: EC/14/014 approved on 5 March 2014). In this context, we aimed to explore MR morphologic features of meningioma which could predict two known poor prognostic factors peritumoral oedema and mass effect. Nonetheless, another study based on computerized tomograms failed to show any association between the location and the size of oedema. In contrast, Lobato et al found only a moderate increase in risk of oedema with tentorial lesions, whereas tumours located in the frontal convexity and the middle third of the falx had highest odds of peritumoral oedema. Simis also described that tentorial meningiomas have less peritumoral oedema. Gawlitza et al found no associations between peritumoral oedema indices and the tumour size, whereas Lobato and Simis found that the larger tumours are associated with a higher risk of associated perilesional oedema on the MRI. Therefore, it is essential to have a mechanism of prognostication on MR diagnosis of meningioma, which will give directive for regular monitoring as well as for deciding on surgical intervention.įindings of the previous studies looking for associations between poor prognostic factors such as perilesional oedema, and MRI morphology of tumour such as tumour size, location are controversial. Moreover, a higher ratio of oedema to tumour volume is also a significant predictor of mortality. The presence of peritumoral oedema (Figure 1A) and mass effect (Figure 1B) in patients with meningioma is reported to have higher odds of developing complications and poor clinical outcomes. Įven though the majority of meningiomas are benign, they can be associated with significant morbidity and mortality, caused by the effects of the tumour, as well as by the adverse effects of treatment. The current modality of choice for diagnostic imaging of meningioma is magnetic resonance imaging (MRI). While being the commonest extra axial tumour encountered in the neurosurgical practice, the reported incidence of meningiomas is rising steadily.

Meningioma is a tumour originating from the leptomeningeal layers of the brain and spinal cord accounting for approximately 30% of all primary intracranial tumours.

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