Computed tomography and magnetic resonance appearance of sporadic meningioangiomatosis correlated with pathological findings

J Comput Assist Tomogr. 2009 Sep-Oct;33(5):799-804. doi: 10.1097/RCT.0b013e31819343e1.


Purpose: Meningioangiomatosis (MA) is a rare benign localized lesion of leptomeninges and underlying cerebral cortex. Preoperative diagnosis is difficult and challenging because of its diverse clinical, pathological, and imaging features. We retrospectively analyzed 7 cases of MA to explore their imaging features and correlate with pathological findings.

Materials and methods: Imaging studies including computed tomography (CT) and magnetic resonance imaging (MRI) were retrospectively reviewed in 7 patients with surgically and pathologically verified intracranial MA (not associated with neurofibromatosis). Computed tomography studies were performed in axial plane without iodinated contrast-material administration; magnetic resonance studies consisted of axial T1-weighted, T2-weighted, Fluid attenuated Inversion Recovery (FLAIR), and postcontrast T1-weighted sequences and coronal or sagittal precontrast and postcontrast T1-weighted sequences.

Results: Computed tomography showed focal extensively calcified lesions in 3 cases, lesions with patchy calcification in 2 cases, and no apparent calcification in 2 cases. Magnetic resonance imaging demonstrated predominantly hypointensity on T1-weighted images and hyperintensity on T2-weighted images. Six of 7 cases exhibited gyriform hyperintensity on FLAIR sequences, which correlated with proliferating microvessels with perivascular cuffs of spindle-cell proliferation within the cortex on histopathological analysis. After contrast-material administration, all but 1 showed heterogeneous enhancement. The nonenhancing lesion on MRI was completely calcified on CT.

Conclusion: Gyriform hyperintensity on FLAIR sequence is the main MRI feature of MA, which correlates with proliferating microvessels with perivascular cuffs of spindle-cell proliferation within the cortex on pathological analysis. Plain CT scan is essential to demonstrate the extent of calcification of these lesions.

MeSH terms

  • Adolescent
  • Adult
  • Angiomatosis / diagnosis*
  • Angiomatosis / pathology
  • Arteriovenous Malformations / diagnosis
  • Brain Neoplasms / diagnosis
  • Calcinosis / diagnosis
  • Calcinosis / pathology
  • Child
  • Contrast Media
  • Diagnosis, Differential
  • Diagnostic Errors
  • Female
  • Glioma / diagnosis
  • Humans
  • Image Enhancement / methods
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms / blood supply*
  • Meningeal Neoplasms / diagnosis*
  • Meningeal Neoplasms / pathology
  • Meningioma / blood supply*
  • Meningioma / diagnosis*
  • Meningioma / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Young Adult


  • Contrast Media