Comparative Analysis of the MRI Characteristics of Meningiomas According to the 2016 WHO Pathological Classification

OBJECTS: To evaluate the performance of preoperative magnetic resonance imaging (MRI) in evaluating diagnoses, operation methods and recurrence of meningiomas according to the World health organization (WHO) pathological classification. METHODS: MRI characteristics of 127 meningioma patients were retrospectively analysed according to pathological results (WHO grade) and their association with Simpson’s grades (resection) and recurrence. RESULTS: The T1-weighted imaging (T1WI) signal intensity of WHO grade I meningiomas was slightly hypointense or isointense gray, while the T2-weighted imaging (T2WI) signal intensity was isointense or slightly hyperintense. The T1WI and T2WI signal intensity in WHO grade II and III meningiomas was isointense gray. The enhancement degree and patterns, lobulation, flowing voids, dural tail, maximum diameter, peritumoural oedema, ADC values and margin were significantly different between any 2 grades (P < 0.05). The ADC values were higher for WHO grade I tumors than for WHO grade II and III tumors (P < 0.001). Among all the analyzed characteriscs, ADC values, peritumoural oedema, and margin effectively predicted the diagnosis according to the WHO classification. The operation method and surgical resection were different between WHO grade Ⅰ and WHO grade Ⅱ/Ⅲ meningiomas (P < 0.05). The recurrence rate increased with tumor grade, but there was no statistical difference among the 3 types(P> 0.05). CONCLUSIONS: WHO grades and pathological subtypes of meningiomas can generally be determined based on their MRI characteristics. In addition, MRI provides significant guidance for the grading of surgical success and prognosis.