Das meningeale zeichen: Eine neubewertung

Purpose: To evaluate the occurrence of the meningeal sign in meningiomas and metastases. Material and methods: We studied 20 patients with meningiomas and 17 patients with cerebral metastases adjacent to the dura. MRI studies (Siemens, Magnetom 1,5) included axial T₁-weighted and T₂-weighted unenhanced as well as gadolinium-DTPA enhanced T₁-weighted (axial, coronal, sagittal) SE imaging. In all patients the tumours were resected with the attached dura mater. Histopathological examinations were done, which corresponded to the area of marked enhancement by gadolinium-DTPA. There was no correlation between the occurrence of the meningeal sign and the histopathological examinations. Results: In 20 patients with meningiomas adjacent to the dura we found the meningeal sign in 11 cases. Histologically we observed an increase of collagen fibres and fibrocytes. In 5 of 17 cases with superficial cerebral metastases the meningeal sign was seen, histologically as dura infiltrations and microbleedings. Conclusion: The meningeal sign is not specific for meningiomas and can be observed in a wide variety of pathological entities.