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Figures
- Fig 1.
Meningiomas with chordoid histology. A–D, Chordoid meningioma. Axial T2-weighted image (A) demonstrates a T2 hyperintense falcotentorial meningioma with facilitated diffusion on the ADC map (B, white arrow). Hematoxylin-eosin (H&E) stained sections at 20× (C) and 40x (D) magnification demonstrate chains and clusters of epithelioid cells in a basophilic myxoid stroma characteristic of chordoid meningioma. E–H, Meningiomas with focal chordoid features. Axial T2-weighted image (E) demonstrates a T2-hyperintense left posterior parasagittal meningioma. The corresponding ADC map (F) demonstrates a dominant area of signal isointensity (black arrow) with focal facilitated diffusion (white arrow). H&E-stained sections at 40× magnification demonstrate regions of chordoid (G) and conventional meningothelial (H) histology. I–L, Anaplastic meningioma with focal chordoid features. Axial T2-weighted image (I) demonstrates a heterogeneous right sphenoid wing meningioma. The corresponding ADC map (J) demonstrates regions of reduced diffusion (black arrow), suggesting increased tumoral cellularity, with a small focus of facilitated diffusion (white arrow). H&E-stained sections at 40× magnification demonstrate focal regions of chordoid histology (K), with a predominant component of anaplastic meningioma lacking chordoid features (L).
- Fig 2.
Left frontal chordoid meningioma. A, Postcontrast T1-weighted image of a 5.5 × 3.6 cm chordoid meningioma shows clear enhancement with areas of nonenhancement. B, T2-weighted image shows moderate-to-hyperintense signal. C, DWI shows hypointense signal. D, A corresponding ADC map demonstrates marked hyperintense signals from the tumor with resulting ADC and nADC values of 1.84 × 10−3mm2/s and 2.36, respectively.
- Fig 3.
Left cerebellopontine angle nonchordoid meningioma, WHO grade I. A, Postcontrast T1-weighted image shows homogeneous enhancement in the 3.0 × 2.8 cm nonchordoid meningioma. B, T2-weighted image shows moderately intense signals. C, DWI shows isointense signals. D, A corresponding ADC map demonstrates isointense signal with resulting ADC and nADC values of 0.94 × 10−3mm2/s and 1.26, respectively.
- Fig 4.
Distribution of ADC and nADC values between chordoid and nonchordoid meningiomas. Boxplots of ADC (×10−6mm2/s) (A) and nADC (B) values of nonchordoid (gray) and chordoid meningiomas (red).
- Fig 5.
Distribution of ADC and nADC values by an intratumoral proportion of chordoid histology. Boxplots of ADC (×10−6mm2/s) (A) and nADC (B) values of chordoid meningiomas (red) and meningiomas with focal chordoid features (orange).
- Fig 6.
ADC and nADC values among chordoid meningioma, meningiomas with focal chordoid histology, and nonchordoid meningiomas. Boxplots of ADC (×10−6mm2/s) (A) and nADC (B) values of chordoid meningiomas (red), meningiomas with focal chordoid features (orange), and nonchordoid meningiomas (green).
Tables
Univariate analysis of qualitative MR imaging features for chordoid meningioma
Predictor Variables Chordoid Meningioma (N = 21) OR (95% CI) P Value Supratentorial location 1.43 (0.43–4.75) .555 Multifocality 4.06 (0.87–19.04) .075 T1 hyperintensity 1.34 (0.46–3.91) .590 T1+ marked CEa 6.49 (0.93 to +inf) .061 T2 hyperintensity 2.91 (0.90–9.40) .074 ADC hyperintensity 4.29 (1.31–13.98) .016b Presence of dural taila 0.50 (0–19.50) .667 Bony involvement 3.10 (0.86–8.06) .090 Cystic/necrotic change 2.31 (0.59–9.11) .231 Sunburst vessels 1.00 (0.29–3.42) 1.000 Venous involvementa 1.57 (0.21–10.40) .859 Arterial narrowing 0.48 (0.05–4.54) .518 CSF cleft 0.44 (0.14–1.40) .165 Parenchymal edema 1.10 (0.38–3.24) .856 Irregular marginsa 6.05 (0.88–69.7) .072
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