A review on dural tail sign

Abstract

"Dural tail sign" (DTS) which is a thickening of the dura adjacent to an intracranial pathology on contrast-enhanced T1 MR Images, was first thought to be pathognomonic of meningioma, however, many subsequent studies demonstrated this sign adjacent to various intra- and extra-cranial pathologies and in spinal lesions. In this paper we outline the history, accompanying pathologies and the differentiation and probable pathophysiology of DTS. We also discuss whether we can predict tumoral involvement of the dural tail before surgery and whether the dural tail adjacent to a tumor should be resected.

Keywords: Dural tail sign; Histopathology; Magnetic resonance imaging; Meningioma.

Figure 1

A 65-year-old woman with meningioma and adjacent hyperostosis. Arrows indicates “dural tail sign”.

Figure 2

Imaging findings of pituitary macroadenoma. A: T1W sagittal MRI of brain shows a Pituitary macro-adenoma with extension to the suprasellar cistern; B: After gadolinium injection enhancement is noted in periphery of tumour and dura of dorsum sella (arrows), enhancement is greater than that of the tumour itself. Biopsy proved prolactinoma.

Figure 3

Pathological finding of dural tail sign. A: A 58-year-old female with a tentorial meningioma and dural tail sign; B: Pathology specimen in this case showed a meningioma (arrow) and the attached dura. The dural tail is noted on the right side of the figure (arrowhead). Both the dura beneath the tumor and dural tail contain dilated blood vessels (arrow). There is no dural invasion. HE 30 ×.