Imaging Correlation of Meningioma by CT and MRI among Saudi Patients

Background: Meningiomas are the most common primary intracranial tumors in adults, and accurate preoperative imaging is essential for diagnosis, surgical planning, and risk assessment. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) play complementary roles. Based on our review, no prior research in Saudi Arabia has statistically examined the correlation between CT and MRI findings, specifically tumor consistency, border definition, and signal homogeneity within the same cohort. This study aimed to evaluate demographic patterns and imaging characteristics of intracranial meningiomas in Saudi patients. Methods and Materials: A cross-sectional study was conducted on 100 patients diagnosed with intracranial meningioma at King Saud Medical City from January 2022 to January 2025. Data were collected through a web-based form and imaging reports. Statistical analysis, including chi-square tests, Cohen’s Kappa, and 95% confidence intervals (CIs) were calculated. The study assessed tumor location, morphology, enhancement patterns, peritumoral edema, and vascular involvement. Results: Most patients were female (72%), with peak prevalence in the 51–60-year age group (28%). CT revealed heterogeneous tumor density (56%), calcifications (47%), and hyperostosis (26%). MRI showed 75% of lesions were hypointense on T1-weighted images, 40% were hyperintense on T2-weighted images, and 47% were isointense on T2-weighted FLAIR images. Dural tail appeared in 44%. Significant correlations were found between CT and MRI in tumor consistency (p = 0.001), borders (p < 0.001), and homogeneity (p = 0.002). Cohen’s Kappa showed fair agreement between the two modalities in these features. Diffusion restriction was associated with peritumoral edema (p = 0.002), and calcification with bone changes on CT (p < 0.001). Conclusion: This study provides region-specific evidence of CT–MRI correlations in meningiomas among Saudi patients. CT is essential for detecting calcification and bone involvement, whereas MRI better characterizes soft tissue features and peritumoral changes. Combined , both modalities enhance diagnostic confidence and preoperative planning.