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We evaluated 17 children with primary intracranial neoplasms for subarachnoid metastatic disease(SAMD)using myelography with computed tomographic follow-up(Myelo+CT)and cerebrospinal fluid(CSF)histopathologic examination as well as magnetic resonance imaging with gadolinium DTPA (MRI+Gd),between December 1988 and December 1989.There were 12 boys,and the median age was 5.7 years(range,0.8 to 21.8 years).Tumor histology included 8 primitive neuroectodermal tumors(PNETs),3 ependymomas,2 low- grade astrocytomas,1 anaplastic astrocytoma,1 glioblastoma multiforme,1 atypical rhabdoid tumor,and 1 malignant fibrous histiocytoma.Thirteen tumors originated in the posterior fossa,2 were supratentorial,and 2 were in the spinal cord.The medial interval between the 2 diagnostic tests was 2 days.MRI+Gd was positive in 11(65%),Myelo+CT in 8(47%),and CSF in 5(29%) cases.MRI+Gd was superior in delineating spinal cord nodules and"sugar coating"whereas Myelo+Ct more readily revealed nerve root sleeve filling defects.There was no case in which Myelo+Ct was positive that MRI+Gd did not reveal SAMD.MRI+Gd is a safe,noninvasive test that should be used as the initial imaging modality for the presence of SAMD. |
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astrocytoma CAT scan CAT scan,metrizamide CAT scan,myelogram with cerebrospinal fluid cerebrospinal fluid,cytology cerebrospinal fluid,cytology,false negative gadolinium glioblastoma multiforme(astrocytoma Gr.III) meningeal gliomatosis MRI MRI,abnormal MRI,contrast enhanced neoplasm,posterior fossa neoplasm,primary intracranial neoplasm,primary of CNS neoplasm,primary of CNS-children neoplasm,primary of CNS-metastasizing to subarachnoid space
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