MR imaging characteristics of slow- and rapid-growing meningiomas: a cohort study of 165 cases

Abstract Introduction: The growth rate of meningiomas varies greatly (0.01 to 2.58 cm3/year).An inappropriate ‘wait and see’ treatment strategy, such as a follow-up interval of MRI longer than 2 years, for rapid growing meningioma (RGM) may seriously increase the risk of subsequent surgery and may eliminate the opportunity for operation. Our purpose was to compare the MR imaging features of slow-growing meningiomas (SGMs) and RGMs and identify the factors that could predict RGM.Methods: We retrospectively collected SGM and RGM data between 2016 and 2021 in Beijing Tiantan Hospital and then used IBM SPSS software to analyze the clinical and MR imaging features between the two groups.Results: Eighty-seven SGM and 78 RGM were collected in our study. Male sex had a 2.896-fold risk of predicting RGM in multivariate analysis (P = 0.048). Patient age, tumor shape and location showed no significant difference between the two groups (P = 0.562, P = 0.514, P = 0.094, respectively). Meningiomas with diameters > 2.5 cm had a higher risk of growing rapidly (multivariate analysis, HR: 3.484, P = 0.006). The presence of peritumoral edema and absence of hypointensity on T2W-MRI were significantly associated with RGM (multivariate analysis; HR: 6.990, P < 0.001; HR: 3.753, P = 0.008;, respectively).Conclusions: Male sex, peritumoral edema, tumor size > 2.5 cm and absence of hypointensity on T2W-MRI may indicate the potential for rapid growth of meningiomas.