The meningocaudal sign is not exclusive to meningioma

It is not necessarily a meningioma, but it may also be lymphoma, metastases, malignant glioma, primitive neuroectodermal tumor, melanoma, plasma cell granuloma, infectious meningitis, eosinophilic granuloma, Wegener granuloma, etc

【Classic case】

1.
Lymphoma

Differentiation from meningioma:

Similarities: T2 signal is not high, edema is obvious, the enhancement is significantly strengthened, and the "meningocaudal sign" (red arrow) can be seen.

Differences: meningiomas are often accompanied by cranial plate thickening with calcifications, clear margins, and often no burr signs (blue arrows)

2.
Metastases

(The primary tumor in this case is lung cancer, and the meningeal tail sign pointed to by the arrow)

3.
Plasma cell granuloma

(It is a rare idiopathic inflammatory granulomatous lesion in the skull, characterized by polyclonal plasma cell proliferation, and the meningocaudal sign can also be seen on imaging findings, which is difficult to distinguish from meningioma)

4.
Peripheral primitive neuroectodermal tumor

5.
Gliosarcoma

6.
Melanoma

(Typical T1 short-signal lesion)

7.
Finally, a classic meningioma

In conclusion, the "tail of meningees" is an important sign of imaging, often present in meningioma, but it is not specific to meningioma, and may occur when the meninges are invaded by the tumor or when there are reactive changes in the meninges
.
Therefore, in work, we cannot rely on the "meningocaudal sign" alone to diagnose meningioma
.