Signal value difference between white matter and tumor parenchyma in T1- and T2- weighted images may help differentiating solitary fibrous tumor/ hemangiopericytoma and angiomatous meningioma

Background: Solitary fibrous tumor / hemangiopericytoma (SFT/HPC) has a similar radiographic appearance to angiomatous meningioma (AM). However, not like angiomatous meningioma with benign outcome, SFT/HPC tend to exhibit aggressive behavior. Distinguishing them preoperatively is important for determining the treatment and follow-up plan.The aim of this study was to determine the clinical and radiographic factors that can be used to differentiate SFT/HPC from AM.

Methods: The analysis included 57 cases of SFT/ HPC and 64 cases of angiomatous meningioma. Clinical characteristics and conventional magnetic resonance imaging were evaluated via multivariate logistic regression analysis using IBM SPSS to identify the factors that distinguish SFT/HPC from angiomatous meningioma.

Rerults: Patients with SFT/HPC were younger than those with angiomatous meningioma (mean age: 47.4 years VS 54.8 years, P = 0.001). The mean maximum diameter of SFTs/ HPCs was larger than that of angiomatous meningiomas (4.9 cm VS 3.5 cm, p < 0.001). Angiomatous meningiomas were more likely with dural tail sign (p < 0.001) and serious peritumoral edema (p < 0.001) compared with SFTs/HPCs. Tumor with signal value difference between white matter and tumor parenchyma in T1- weighted images between -20 to 100 or in T2- weighted images between -220 to 20 may be, with high probability, a SFT/ HPC instead of a AM.

Conclusion: Age, tumor size, dural tail sign, peritumoral edema, signal value difference between white matter and tumor parenchyma in T1- and T2- weighted images may help distinguishing SFT/HPC from angiomatous meningioma preoperatively.

Keywords: Angiomatous meningioma; MRI; SFT/HPC.