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<meta name="DC.Title" content="Chordoid Meningioma: Differentiating a Rare World Health Organization Grade II Tumor from Other Meningioma Histologic Subtypes Using MRI" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4309" />
<meta name="DC.Date" content="2015-07-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2015 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Meningiomas are very commonly diagnosed intracranial primary neoplasms, of which the chordoid subtype is seldom encountered. Our aim was to retrospectively review preoperative MR imaging of intracranial chordoid meningiomas, a rare WHO grade II variant, in an effort to determine if there exist distinguishing MR imaging characteristics that can aid in differentiating this atypical variety from other meningioma subtypes.

MATERIALS AND METHODS: Ten cases of WHO grade II chordoid meningioma were diagnosed at our institution over an 11-year span, 8 of which had preoperative MR imaging available for review and were included in our analysis. Chordoid meningioma MR imaging characteristics, including ADC values and normalized ADC ratios, were compared with those of 80 consecutive cases of WHO grade I meningioma, 21 consecutive cases of nonchordoid WHO grade II meningioma, and 1 case of WHO grade III meningioma.

RESULTS: Preoperative MR imaging revealed no significant differences in size, location, signal characteristics, or contrast enhancement between chordoid meningiomas and other meningiomas. There were, however, clear differences in the ADC values and normalized ADC ratios, with a mean absolute ADC value of 1.62 ± 0.33 × 10−3 mm2/s and a mean normalized ADC ratio of 2.22 ± 0.47 × 10−3 mm2/s in chordoid meningiomas compared with mean ADC and normalized ADC values, respectively, of 0.88 ± 0.13 × 10−3 mm2/s and 1.17 ± 0.16 × 10−3 mm2/s in benign WHO grade I meningiomas, 0.84 ± 0.11 × 10−3 mm2/s and 1.11 ± 0.15 × 10−3 mm2/s in nonchordoid WHO grade II meningiomas, and 0.57 × 10−3 mm2/s and 0.75 × 10−3 mm2/s in the 1 WHO grade III meningioma.

CONCLUSIONS: Chordoid meningiomas have statistically significant elevations of ADC and normalized ADC values when compared with all other WHO grade I, II, and III subtypes, which enables reliable preoperative prediction of this atypical histopathologic diagnosis.

NADC
:   normalized ADC
WHO
:   World Health Organization" />
<meta name="DC.Contributor" content="J.B. Pond" />
<meta name="DC.Contributor" content="T.G. Morgan" />
<meta name="DC.Contributor" content="K.J. Hatanpaa" />
<meta name="DC.Contributor" content="Z.F. Yetkin" />
<meta name="DC.Contributor" content="B.E. Mickey" />
<meta name="DC.Contributor" content="D.B. Mendelsohn" />
<meta name="article:published_time" content="2015-07-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Chordoid Meningioma: Differentiating a Rare World Health Organization Grade II Tumor from Other Meningioma Histologic Subtypes Using MRI" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Meningiomas are very commonly diagnosed intracranial primary neoplasms, of which the chordoid subtype is seldom encountered. Our aim was to retrospectively review preoperative MR imaging of intracranial chordoid meningiomas, a rare WHO grade II variant, in an effort to determine if there exist distinguishing MR imaging characteristics that can aid in differentiating this atypical variety from other meningioma subtypes.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Ten cases of WHO grade II chordoid meningioma were diagnosed at our institution over an 11-year span, 8 of which had preoperative MR imaging available for review and were included in our analysis. Chordoid meningioma MR imaging characteristics, including ADC values and normalized ADC ratios, were compared with those of 80 consecutive cases of WHO grade I meningioma, 21 consecutive cases of nonchordoid WHO grade II meningioma, and 1 case of WHO grade III meningioma.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Preoperative MR imaging revealed no significant differences in size, location, signal characteristics, or contrast enhancement between chordoid meningiomas and other meningiomas. There were, however, clear differences in the ADC values and normalized ADC ratios, with a mean absolute ADC value of 1.62 ± 0.33 × 10&lt;sup&gt;−3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s and a mean normalized ADC ratio of 2.22 ± 0.47 × 10&lt;sup&gt;−3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s in chordoid meningiomas compared with mean ADC and normalized ADC values, respectively, of 0.88 ± 0.13 × 10&lt;sup&gt;−3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s and 1.17 ± 0.16 × 10&lt;sup&gt;−3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s in benign WHO grade I meningiomas, 0.84 ± 0.11 × 10&lt;sup&gt;−3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s and 1.11 ± 0.15 × 10&lt;sup&gt;−3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s in nonchordoid WHO grade II meningiomas, and 0.57 × 10&lt;sup&gt;−3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s and 0.75 × 10&lt;sup&gt;−3&lt;/sup&gt; mm&lt;sup&gt;2&lt;/sup&gt;/s in the 1 WHO grade III meningioma.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Chordoid meningiomas have statistically significant elevations of ADC and normalized ADC values when compared with all other WHO grade I, II, and III subtypes, which enables reliable preoperative prediction of this atypical histopathologic diagnosis.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2015/07/01" />
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<meta name="citation_doi" content="10.3174/ajnr.A4309" />
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<meta name="citation_volume" content="36" />
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<meta name="citation_section" content="Adult Brain" />
<meta name="citation_firstpage" content="1253" />
<meta name="citation_lastpage" content="1258" />
<meta name="citation_author" content="J.B. Pond" />
<meta name="citation_author_institution" content="aFrom the Departments of Neuroradiology (J.B.P., T.G.M., Z.F.Y., D.B.M.)" />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-4120-6035" />
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<meta name="citation_author" content="K.J. Hatanpaa" />
<meta name="citation_author_institution" content="bNeuropathology (K.J.H.)" />
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<meta name="twitter:title" content="Chordoid Meningioma: Differentiating a Rare World Health Organization Grade II Tumor from Other Meningioma Histologic Subtypes Using MRI" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Meningiomas are very commonly diagnosed intracranial primary neoplasms, of which the chordoid subtype is seldom encountered. Our aim was to retrospectively review preoperative MR imaging of intracranial chordoid meningiomas, a rare WHO grade II variant, in an effort to determine if there exist distinguishing MR imaging characteristics that can aid in differentiating this atypical variety from other meningioma subtypes.

MATERIALS AND METHODS: Ten cases of WHO grade II chordoid meningioma were diagnosed at our institution over an 11-year span, 8 of which had preoperative MR imaging available for review and were included in our analysis. Chordoid meningioma MR imaging characteristics, including ADC values and normalized ADC ratios, were compared with those of 80 consecutive cases of WHO grade I meningioma, 21 consecutive cases of nonchordoid WHO grade II meningioma, and 1 case of WHO grade III meningioma.

RESULTS: Preoperative MR imaging revealed no significant differences in size, location, signal characteristics, or contrast enhancement between chordoid meningiomas and other meningiomas. There were, however, clear differences in the ADC values and normalized ADC ratios, with a mean absolute ADC value of 1.62 ± 0.33 × 10−3 mm2/s and a mean normalized ADC ratio of 2.22 ± 0.47 × 10−3 mm2/s in chordoid meningiomas compared with mean ADC and normalized ADC values, respectively, of 0.88 ± 0.13 × 10−3 mm2/s and 1.17 ± 0.16 × 10−3 mm2/s in benign WHO grade I meningiomas, 0.84 ± 0.11 × 10−3 mm2/s and 1.11 ± 0.15 × 10−3 mm2/s in nonchordoid WHO grade II meningiomas, and 0.57 × 10−3 mm2/s and 0.75 × 10−3 mm2/s in the 1 WHO grade III meningioma.

CONCLUSIONS: Chordoid meningiomas have statistically significant elevations of ADC and normalized ADC values when compared with all other WHO grade I, II, and III subtypes, which enables reliable preoperative prediction of this atypical histopathologic diagnosis.

NADC
:   normalized ADC
WHO
:   World Health Organization" />
<meta name="og-title" property="og:title" content="Chordoid Meningioma: Differentiating a Rare World Health Organization Grade II Tumor from Other Meningioma Histologic Subtypes Using MRI" />
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<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Meningiomas are very commonly diagnosed intracranial primary neoplasms, of which the chordoid subtype is seldom encountered. Our aim was to retrospectively review preoperative MR imaging of intracranial chordoid meningiomas, a rare WHO grade II variant, in an effort to determine if there exist distinguishing MR imaging characteristics that can aid in differentiating this atypical variety from other meningioma subtypes.

MATERIALS AND METHODS: Ten cases of WHO grade II chordoid meningioma were diagnosed at our institution over an 11-year span, 8 of which had preoperative MR imaging available for review and were included in our analysis. Chordoid meningioma MR imaging characteristics, including ADC values and normalized ADC ratios, were compared with those of 80 consecutive cases of WHO grade I meningioma, 21 consecutive cases of nonchordoid WHO grade II meningioma, and 1 case of WHO grade III meningioma.

RESULTS: Preoperative MR imaging revealed no significant differences in size, location, signal characteristics, or contrast enhancement between chordoid meningiomas and other meningiomas. There were, however, clear differences in the ADC values and normalized ADC ratios, with a mean absolute ADC value of 1.62 ± 0.33 × 10−3 mm2/s and a mean normalized ADC ratio of 2.22 ± 0.47 × 10−3 mm2/s in chordoid meningiomas compared with mean ADC and normalized ADC values, respectively, of 0.88 ± 0.13 × 10−3 mm2/s and 1.17 ± 0.16 × 10−3 mm2/s in benign WHO grade I meningiomas, 0.84 ± 0.11 × 10−3 mm2/s and 1.11 ± 0.15 × 10−3 mm2/s in nonchordoid WHO grade II meningiomas, and 0.57 × 10−3 mm2/s and 0.75 × 10−3 mm2/s in the 1 WHO grade III meningioma.

CONCLUSIONS: Chordoid meningiomas have statistically significant elevations of ADC and normalized ADC values when compared with all other WHO grade I, II, and III subtypes, which enables reliable preoperative prediction of this atypical histopathologic diagnosis.

NADC
:   normalized ADC
WHO
:   World Health Organization" />
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      <h1 class="highwire-cite-title" id="page-title">Chordoid Meningioma: Differentiating a Rare World Health Organization Grade II Tumor from Other Meningioma Histologic Subtypes Using MRI</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J.B. Pond</span>, <span class="highwire-citation-author" data-delta="1">T.G. Morgan</span>, <span class="highwire-citation-author" data-delta="2">K.J. Hatanpaa</span>, <span class="highwire-citation-author" data-delta="3">Z.F. Yetkin</span>, <span class="highwire-citation-author" data-delta="4">B.E. Mickey</span> and <span class="highwire-citation-author" data-delta="5">D.B. Mendelsohn</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">July 2015,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1253-1258; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4309 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14090--6759440913" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J.B. Pond </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroradiology (J.B.P., T.G.M., Z.F.Y., D.B.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.B.%2BPond%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pond%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.B.%2BPond%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4120-6035" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.B. Pond</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">T.G. Morgan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroradiology (J.B.P., T.G.M., Z.F.Y., D.B.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.G.%2BMorgan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Morgan%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.G.%2BMorgan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">K.J. Hatanpaa </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neuropathology (K.J.H.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.J.%2BHatanpaa%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hatanpaa%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AK.J.%2BHatanpaa%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Z.F. Yetkin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroradiology (J.B.P., T.G.M., Z.F.Y., D.B.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.F.%2BYetkin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yetkin%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AZ.F.%2BYetkin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">B.E. Mickey </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurosurgery (B.E.M.), University of Texas Southwestern Medical Center, Dallas, Texas.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.E.%2BMickey%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mickey%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AB.E.%2BMickey%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D.B. 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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jul 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1253-1258; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4309 </span></div>
  
  
  
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