Which imaging feature is typical of a cerebral meningioma?

• A. Non-enhancing cystic lesion.
• B. Intensely enhancing, well-defined lesion attached to the dura.
• C. Diffuse white-matter atrophy.
• D. Ring-enhancing lesion with central necrosis.

Answer: (B)

Meningiomas classically appear as an intensely enhancing, well-defined mass that is attached to the dura. This reflects their origin from arachnoid cap cells and their status as extra-axial tumors with a broad dural-based contact. On imaging, the lesion tends to be homogeneous in contrast enhancement and often shows a dural tail sign—thickening and enhancement of the overlying dura—which helps distinguish it from intra-axial tumors. Other options don’t fit this pattern: a non-enhancing cystic lesion suggests a cyst rather than a solid, dural-attached tumor; diffuse white-matter atrophy reflects neurodegeneration rather than a mass; a ring-enhancing lesion with central necrosis points toward abscess or high-grade glioma, not a typical meningioma.