Title: CT and MR imaging in the evaluation of leptomeningeal metastases
Abstract: Objective To study the manifestations of leptomeningeal metastases on CT and MR imaging, and evaluate the diagnostic significance of both modalities for this disease. Methods Clinical and neuroradiological data of 21 cases with leptomeningeal metastases were retrospectively reviewed. In this series, 16 patients were studied by CT and 7 patients by MRI, 2 patients by both CT and MRI. Results Abnormal enhancement of pia and subarachnoid space, appearing as diffuse pattern in 10 cases, nodular pattern in 8 cases and mixed pattern with diffuse plus nodules in 3 cases, were visualized by CE CT and Gd MRI. Diffuse enhancement followed the convolutions of gyri and surface of brainstem, and extended into cerebral cisterns and sulci. The foci appeared as enhanced nodules 0.2-3.0 cm in diameter and 1 or more in number. Nodules with infiltration of cerebral parenchymal were found in 4 patients. In 86% of all cases, diffuse or nodular foci occurred in basilar cysterns and adjacent cerebellar and cerebral sulci. There were 4 cases associated with ependymal nodular enhancement and 10 cases with widened irregular tentorial enhancement. Intracerebral metastases in 9 cases and hydrocephalus in 13 cases were found in this series. Conclusions CE CT and Gd MRI are had significant clinical dignostic value for leptomeningeal metastases, Gd MRI is superior to CE CT. Because of the limitation in the evaluation of leptomeningeal invasion by neoplasms on CT and MRI, definitive diagnosis of leptomeningeal metastases depends on combination of clinical and imaging data.
Publication Year: 1999
Publication Date: 1999-01-01
Language: en
Type: article
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Cited By Count: 1
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