Preoperative radiologic characters to predict hemangiopericytoma from angiomatous meningioma.

Background: Hemangiopericytoma is clinically difficult to be differentiated from angiomatous meningioma. We set out to determine if the preoperative MRI parameters can predict HPC from angiomatous meningioma.

Methods: A retrospective review of medical records was conducted for12 HPC patients and 17 angiomatous meningiomas. WHO-2007 grading was used for histopathological diagnosis. Preoperative radiologic parameters included tumor location, tumor size, tumor shape, T1-weighted signal, T2-weighted signal, T1-weighted Gd-enhanced image, ADC value, Flair signal, peritumoral edema (PTE), dural tail sign (DTS), vessel voids sign, arachnoid layer on T2-weighted MRI, tumor hemorrhage and necrosis were analyzed. Univariate analyses were conducted to examine the association between radiological or clinical and histopathological features. Binary logistic regression model was used to evaluate if the parameters predict the occurrence of HPC.

Results: Five parameters, included age, gender, ADC value, necrosis and T1 enhancement was found significantly different between two types after univariate analyses. Binary logistic regression model demonstrated ADC value was the sole independent predictor of HPC (p=0.039, OR: 14.5, CI-3.7-38.6).

Conclusions: ADC value may be used as a simple and useful optional tool in differentiating primary intracranial HPC from angiomatous meningioma. The combination of ADC value with the data acquired from pre and post-contrast MR scans may further help improve the reliability in the differential diagnosis.