Spoke wheel sign (meningioma)

Last revised by Intejar ali on 30 Jan 2023

The spoke wheel sign refers to the pattern of vessels coursing through meningiomas, when seen in cross-section.  It is the result of the same phenomenon which results in the sunburst pattern (vessels seen from the side rather than in cross-section).

A similar appearance also referred to as a spoke wheel sign may also be seen in renal tumors (e.g. oncocytoma) - see spoke wheel vascularity - kidney.

The vascular supply of meningiomas is often both dural and pial. Classically, the central region of a meningioma is supplied by dural feeders at the site of dural attachment, while the capsule is fed by pial or cortical feeders.

The feeder arterial branches diverge radially into the lesion; this gives the appearance of a spoke wheel on T2-weighted or post contrast images, or during angiography.

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