Meningiomas: Clinical correlates, skull x-ray, CT and patological evaluations
Ethiopian Medical Journal
Department of Radiology, Addis Ababa University, Ethiopia; Department of Pathology, Addis Ababa University, Ethiopia; Department of Surgery, Neurosurgery Unit, Addis Ababa University, Ethiopia
Objective: To assess the frequency and the diagnostic performance of plain skull x-ray and and CT of meningiomas. Methods: All pathologically diagnosed intracranial meningiomas in patients seen at Tikur Anbessa Hospitals were reviewed. Results: Between December 1999 and July 2004 there were 25 histologically diagnosed cases of meningioma at the Tikur Anbessa Hospital (TAH). The duration of symptoms was ranging from 0.5-10yrs (mean 2.4±2.1yrs) and age ranging from 21-57yrs (mean age of 49.3±10yrs) with M: F ratio of 1.2: 1. Blurring of vision was the commonest clinical presentation. Clinical correlates, skull x-rays, computerized tomographic results and pathology are evaluated. Plain skull x-ray findings were normal in 12/23 (52%); 10/23(43%) of the cases had non-specific sellar changes of raised intra-cranial pressure. Twenty-three of the 25 meningiomas had CT scanning done, and CT diagnosed 17/23(74%) meningiomas correctly. Two meningiomas were unusual in location: one was intranasal and the other was intra-ventricular. Parasellar tumors were frequent sites of misdiagnosis. The commonest locations were parasellar and cerebral convexity, each accounting for 6/25(24%) of the cases. The commonest CT observation was intense and homogeneous enhancement 15/23 (65%). Meningothelial meningioma was the commonest cellular type accounting for 11/25(46%) of the pathologies followed by the transitional 4/25 (16%) and the atypical and psammomatous types, each with equal frequency, 3/25 (12%). Conclusion: CT scan had a diagnostic accuracy of 83%, sensitivity of 74%, specificity of 95%, positive predictive value (PPV) of 95%, and negative predictive value (NPV) of 75%. Statistical analysis verifies the pre-operative reliability for diagnosing meningiomas by CT scanning.
adult; article; computer assisted tomography; female; human; male; meningioma; middle aged; pathology; radiography; retrospective study; skull; Adult; Female; Humans; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Retrospective Studies; Skull; Tomography, X-Ray Computed