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Research ArticleHEAD & NECK

Intratumoral Microhemorrhages on T2*-Weighted Gradient-Echo Imaging Helps Differentiate Vestibular Schwannoma From Meningioma

K. Thamburaj, V.V. Radhakrishnan, B. Thomas, S. Nair and G. Menon
American Journal of Neuroradiology March 2008, 29 (3) 552-557; DOI: https://doi.org/10.3174/ajnr.A0887
K. Thamburaj
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V.V. Radhakrishnan
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B. Thomas
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S. Nair
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G. Menon
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    Fig 1.

    A–B, Axial T2- and T1-weighted images, respectively, of left VS show no evidence of hemorrhage (arrow). Note the extension into the IAC (arrowhead). C, Photomicrograph shows the Antoni A (+) and Antoni B (*) components in the VS (H&E ×150). D, Axial postcontrast T1-weighted image shows bright enhancement of the tumor with nonenhancing areas (arrow). E, T2*-weighted GRE shows multiple hypointense intratumoral signals suggestive of microhemorrhage. F, Photomicrograph showing discrete and confluent masses of hemosiderin pigments (arrow) in the Schwann cell tumor (Perls stain ×150).

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    Fig 2.

    A, T1-weighted postgadolinium axial image shows right CPA meningioma with extension into the adjacent IAC (arrow). B, T1-weighted postgadolinium coronal image shows extension of the tumor into the IAC more clearly (arrow) compared with the contralateral IAC (arrowhead).

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    Fig 3.

    A, Axial T2-weighted TSE image shows the relatively hyperintense meningioma in the right CPA with a broad base against the petrous bone (arrow). Note the vasogenic edema of the adjacent cerebellum and middle cerebellar peduncle (star). B, On axial T1-weighted SE, the tumor is isointense to the brain. C, Postcontrast T1-weighted image at the corresponding level shows intense enhancement of the tumor (arrow). D, Axial T2*-weighted GRE does not show hypointense signals characteristic of microhemorrhage in the tumor (arrow). The tumor matrix appears homogeneous. E, Photomicrograph showing features of a meningioma in which neoplastic cells are displayed in concentric whorls and lobules of varying sizes. These neoplastic cells are supported on a vascularized connective stroma (H&E ×150).

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    Table 1:

    VS group

    Patient No.Age/SexLocationSize (cm) T x C x AConsistencyNo. of MHSize of MH (mm)Fluid LevelIAC ComponentSequence Showing MH Other Than T2*Surgical TreatmentPigment
    152/MR3.22 × 3.41 × 2.88S9<3N+NYY
    242/ML3.77 × 3.78 × 4.21S>405N+T2 & FLAIRYY
    341/FR3.03 × 3.57 × 4.14S172N+NYY
    436/FR2.63 × 2.95 × 3.55S144N+NYY
    530/ML3.23 × 3.48 × 3.55S65N+NYY
    660/FR2.82 × 3.1 × 3S52N+NYY
    759/FR3.61 × 2.43 × 2.95S>504N+NYY
    838/FB/L4.02 × 3.95 × 4.67 (R)S>505N+NYY
    2.73 × 2.52 × 3.32 (L)S52N+NNN
    952/MR1.45 × 1.12 × 1.12SNNN+NNN
    1034/MR3.68 × N × 2.88S285N+NYY
    1151/MR3.09 × 4.38 × 4.88C47Y+T2 & FLAIRYY
    1223/FR3.27 × 4.73 × 3.08S64N+NYY
    1336/MR4.40 × 4.20 × 4.03S104N+NYY
    1422/MR3.81 × 4.73 × 3.71S695N+NYY
    1518/MR5.2 × 6.09 × 6.37S1408Y+NYY
    • Note:—M indicates male; F, female; R, right; L, left; B/L, bilateral; S, solid; C, cystic (in Consistency column); N, no; Y, yes; MH, microhemorrhage; IAC, internal auditory canal; T, transverse; C, craniocaudal; A, anteroposterior; FLAIR, fluid-attenuated inversion recovery; +, present.

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    Table 2:

    Meningioma group

    Patient No.Age/SexLocationSize (cm) T × C × AConsistencyNo. of MHSize of MH (mm)Fluid LevelIAC ComponentMH in IACSequence Showing MH Other Than T2*Surgical Treatment
    159/FCPA2.03 × 2.69 × 2.79SNNNNNNY
    247/FTentorium4.55 × 5.64 × 4.97SNNNNNNY
    344/FFalcotentorial2.64 × 3.33 × 2.98SNNNNNNY
    448/FCPA2.22 × 3.54 × 3.32SNNNNNNY
    544/MCPA3.32 × 3.16 × 4.92SNNN+NNY
    • Note:—M indicates male; F, female; S, solid; N, no; Y, yes; MH, microhemorrhage; IAC, internal auditory canal; T, transverse; C, craniocaudal; A, anteroposterior; CPA, cerebellopontine angle; +, present.

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American Journal of Neuroradiology: 29 (3)
American Journal of Neuroradiology
Vol. 29, Issue 3
March 2008
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Cite this article
K. Thamburaj, V.V. Radhakrishnan, B. Thomas, S. Nair, G. Menon
Intratumoral Microhemorrhages on T2*-Weighted Gradient-Echo Imaging Helps Differentiate Vestibular Schwannoma From Meningioma
American Journal of Neuroradiology Mar 2008, 29 (3) 552-557; DOI: 10.3174/ajnr.A0887

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Intratumoral Microhemorrhages on T2*-Weighted Gradient-Echo Imaging Helps Differentiate Vestibular Schwannoma From Meningioma
K. Thamburaj, V.V. Radhakrishnan, B. Thomas, S. Nair, G. Menon
American Journal of Neuroradiology Mar 2008, 29 (3) 552-557; DOI: 10.3174/ajnr.A0887
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