Differentiating intracranial solitary fibrous tumor/hemangiopericytoma from meningioma using diffusion-weighted imaging and susceptibility-weighted imaging.

PURPOSE: Intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) and meningioma are difficult to distinguish owing to their overlapping imaging manifestation on routine magnetic resonance imaging. The purpose of this study was to assess whether SFT/HPC can be differentiated from meningioma with diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI).

METHODS

We retrospectively reviewed DWI, SWI, conventreional MR, and CT imaging features of 16 patients with SFT/HPC and 96 patients with meningioma. The apparent diffusion coefficient (ADC) value, normalized ADC (nADC) value, and degree of intratumoral susceptibility signal intensity (ITSS) were compared between SFT/HPCs and meningiomas using two-sample t tests, and among SFT/HPCs, low-grade and high-grade meningioma were tested using one-way analysis of variance (ANOVA). Receiver operating characteristic (ROC) curve and logistic regression analyses were performed to determine the differentiation capacity.

RESULTS

The ADC value, nADC value, and the degree of ITSS in SFT/HPC were significantly higher than those in low-grade and high-grade meningiomas (all p < 0.05). The threshold value of > 1.15 for nADC provided 75.00% sensitivity and 60.42% specificity for differentiating SFT/HPC from meningioma. Compared with nADC, the degree of ITSS had a moderate sensitivity (62.50%) and a higher specificity (85.42%) using the threshold value of > 1.00. Furthermore, combining DWI and SWI can achieve a relatively high differentiation capacity with a sensitivity of 81.25% and specificity of 78.12%.

CONCLUSIONS

The nADC ratios and ITSS are useful for differentiating SFT/HPC from meningioma. Combining ITSS and nADC value appears to be a promising option for differential diagnosis.