Intracranial solitary fibrous tumor: imaging findings

Eur J Radiol. 2011 Nov;80(2):387-94. doi: 10.1016/j.ejrad.2010.02.016. Epub 2010 Mar 29.

Abstract

Objective: To study the neuroimaging features of intracranial solitary fibrous tumors (ISFTs).

Materials and methods: Retrospective study of neuroimaging features of 9 consecutive histopathologically proven ISFT cases. Location, size, shape, density, signal intensity and gadolinium uptake were studied at CT and MRI. Data collected from diffusion-weighted imaging (DWI) (3 patients), perfusion imaging and MR spectroscopy (2 patients), and DSA (4 patients) were also analyzed.

Results: The tumors most frequently arose from the intracranial meninges (7/9), while the other lesions were intraventricular. Tumor size ranged from 2.5 to 10 cm (mean=6.6 cm). They presented multilobular shape in 6/9 patients. Most ISFTs were heterogeneous (7/9) with areas of low T2 signal intensity that strongly enhanced after gadolinium administration (6/8). Erosion of the skull was present in about half of the cases (4/9). Components with decreased apparent diffusion coefficient were seen in 2/3 ISFTs on DWI. Spectroscopy revealed elevated peaks of choline and myo-inositol. MR perfusion showed features of hyperperfusion.

Conclusion: ISFT should be considered in cases of extra-axial, supratentorial, heterogeneous, hypervascular tumor. Areas of low T2 signal intensity that strongly enhance after gadolinium injection are suggestive of this diagnosis. Restricted diffusion and elevated peak of myo-inositol may be additional valuable features.

MeSH terms

  • Adult
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / metabolism
  • Choline / metabolism
  • Contrast Media
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Heterocyclic Compounds
  • Humans
  • Inositol / metabolism
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • Male
  • Middle Aged
  • Neuroimaging / methods*
  • Organometallic Compounds
  • Retrospective Studies
  • Solitary Fibrous Tumors / diagnosis*
  • Solitary Fibrous Tumors / metabolism
  • Tomography, X-Ray Computed

Substances

  • Contrast Media
  • Heterocyclic Compounds
  • Organometallic Compounds
  • Inositol
  • gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate
  • Choline