Dural tail sign adjacent to different intracranial lesions on contrast-enhanced MR images

Abstract

Introduction: The aim of this study is to determine the prevalence of dural tail sign (DTS) in meningiomas, glioblastomas multiforme, metastasis, pituitary macro-adenomas, acoustic neuromas, medulloblastomas, lymphomas and Wegener's granulomatosis, and to reveal if DTS is specifi c for meningiomas. Methods: In this retrospective, cross sectional study 96 patients were included with 95 intracranial and 1 extracranial lesions. The study was conducted in the period from January 2008 to May 2010 and the group pattern was made consecutively. The patients underwent surgery and all 96 lesions were examined by histopathology analysis. DTS was analysed on contrast T1- weighted spin echo images after injection of 0.1 mmol/kg gadolinium contrast medium. The presence of this sign was defi ned using Goldsher et al's criteria. Results: Histopathology results of the 96 lesions revealed the presence of: 35 meningiomas, 25 glioblastomas multiforme, 13 metastasis, 10 pituitary adenomas, 5 acoustic neuromas, 4 medulloblastomas, 3 lymphomas and 1 Wegener's granulomatosis. On the contrast-enhanced T1 MR images, DTS was noted in 31 (32.3%) lesions, in the following histological samples: meningioma, GBM, adenoma, schwannoma, medulloblastoma and Wegener's granulomatosis, while in the cases of metastasis and lymphomas DTS was not noted. We found the dural tail sign to have a sensitivity of 68.6% and specifi city of 88.5% in the diagnosis of meningioma. Conclusion: The dural tail is a common but not a pathognomic sign of meningioma on contrast-enhanced T1 MR images. Other intracranial lesions, such as glioblastoma multiforme, pituitary adenoma, schwannoma, medulloblastoma and Wegener's granulomatosis may also be represented with this sign.