Differential diagnosis of angiomatous meningioma and atypical meningioma based on contrast enhanced T1-weighted images histogram analysis
Objective:To investigate the value of structural MRI features and enhanced T1-weighted images histogram analysis in the differential diagnosis of atypical meningioma(AtM)and angiomatous meningioma(AnM).Materials and Methods:The clinical,imaging and pathological data of AtM(n=40)and AnM(n=30)were collected retrospectively.The tumor was delineated layer-by-layer on axial enhanced T1-weighted images by MaZda software and histogram parameters of tumor enhancement areas were obtained.Structural MRI characteristics were compared using the chi-square test or Fisher's exact test.Histogram parameters were compared between the two groups using independent samples t-tests or Mann-Whitney U-tests,and diagnostic efficacy between the two groups was assessed by receiver operating characteristic(ROC)curves.Results:The incidence of tumor necrosis was significantly higher in the AtM group(75.0%)than in the AnM group(36.7%)(P=0.001).The mean(P=0.003),1st percentile(P<0.001),10th percentile(P=0.001),and 50th percentile(P=0.009)of the AnM were greater than those of the AtM.ROC curve analysis showed that tumor necrosis + combined histogram parameters had the optimal differential diagnostic efficacy between the two,with area under the curve,sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of 0.858(0.753-0.930),95.00%,66.67%,82.86%,79.20%,and 90.90%.Conclusions:The conventional MRI features and histogram analysis based on enhanced T1-weighted images is helpful in the preoperative non-invasive differentiation of AnM and AtM,of which the diagnostic efficacy is highest in the tumor necrosis + combined histogram parameters.