MRI imaging features and clinical features of chordoid meningioma

YE Ming; WU Zhiqiang; LU Jiacheng; HU Jing; LI Ming; WU Yi; LI Jian; FU Chuanjing; FAN Lian; GAO Juemin; LI Hailin; DUAN Baoqi

doi:10.3969/j.issn.1674-4136.2025.04.009

Abstract：Objective To investigate the MRI imaging features and clinical features of chordoid meningioma(CM).Methods The data of 21 patients with chordoid meningioma confirmed by surgical pathology in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine/Jiangsu Provincial Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Nanjing Medical University/Jiangsu Provincial People's Hospital from January 2008 to December 2023 were collected retrospectively.The CT and MRI manifestations,pathological features,treatment options and prognosis were analyzed.Twenty-eight patients with non-CM meningioma were included as controls,matching gender,age and admission time.Results Of the 21 cases,the tumors were located in the skull in 20 cases and in the cervical vertebra in 1 case.MRI features:tumors were mostly patchy,with isointensity or hypointensity on T1-weighted imaging(T1WI),slightly hyperintense or hyperintense on T2-weighted imaging(T2WI),and obvious enhancement after enhanced scanning;No hypointensity was observed by diffusion-weighted imaging(DWI),and the apparent diffusion coefficient(ADC)value was significantly higher than that of non-chordoid meningiomas group(P<0.05).Pathological features:the fusiform or epithelioid tumor cells were arranged in strips or clusters,and the cytoplasmic vacuoles and"droplet-like"cells were distributed in the rich basophilic mucus-like stroma.Eighteen patients with chordoid meningioma were followed up for 8-147 months(n=18),seven cases relapsed in situ and three cases died.The recurrence rate of patients with total resection of chordoid meningioma was significantly lower than that of patients with subtotal resection(P<0.05),and the recurrence rate of patients with skull involvement was significantly higher than that of patients without skull involvement(P<0.05).Conclusions Apparent diffusion coefficient(ADC)values in MRI are expected to be a reliable indicator to distinguish chordoid meningioma from other meningioma tissues.Total resection of the tumor is the best treatment for chordoid meningioma at present.