M H Pui1, J W Langston, Y Arai. 1. Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN 38105.
Abstract
OBJECTIVE: We report four cases of CSF enhancement secondary to meningeal carcinomatosis observed during MRI. Only one case has been reported previously. MATERIALS AND METHODS: Four patients ranging from 4 to 20 years of age, and all having primary or secondary CNS neoplasms, were examined by cranial and/or spinal MRI before and after Gd-DTPA administration. Three of the patients had additional delayed imaging, and subtraction was used in one case. RESULTS: All four patients demonstrated CSF enhancement after Gd-DTPA administration, which increased on delayed imaging and was more apparent following subtraction. Three of the four patients died within 5 months of the MRI examination. CONCLUSION: CSF enhancement is uncommon, but when seen indicates massive tumor that coats the surface of the CNS. Detection of CNS enhancement may alter therapy; however prognosis may be poor when CSF enhancement is present. Delayed imaging and subtraction may improve detection of CSF enhancement.
OBJECTIVE: We report four cases of CSF enhancement secondary to meningeal carcinomatosis observed during MRI. Only one case has been reported previously. MATERIALS AND METHODS: Four patients ranging from 4 to 20 years of age, and all having primary or secondary CNS neoplasms, were examined by cranial and/or spinal MRI before and after Gd-DTPA administration. Three of the patients had additional delayed imaging, and subtraction was used in one case. RESULTS: All four patients demonstrated CSF enhancement after Gd-DTPA administration, which increased on delayed imaging and was more apparent following subtraction. Three of the four patients died within 5 months of the MRI examination. CONCLUSION:CSF enhancement is uncommon, but when seen indicates massive tumor that coats the surface of the CNS. Detection of CNS enhancement may alter therapy; however prognosis may be poor when CSF enhancement is present. Delayed imaging and subtraction may improve detection of CSF enhancement.