MRI
What is the probable differential diagnosis of such a case? What are the main differentiating points?
Hemangiopericytoma. The main differentiating points are that meningiomas have a smooth surface, maintain a wide dural base, and are more likely to cause calvarial hyperostosis rather than erosion.
A well-defined extra-axial dural-based space-occupying lesion is seen in the region of the falx cerebri. It displays intermediate signal intensity on both T1 and T2 and a relatively high signal on FLAIR WIs. After contrast administration, it shows homogenous enhancement. It shows a relatively high signal on DWIs and a low signal on the ADC maps reflecting diffusion restriction. It is seen surrounded by a mild degree of vasogenic edema. An increased calvarial thickness is seen adjacent to the lesion. These findings are suggestive of meningioma with high cellularity.