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Postcontrast MRI of Cranial Meninges:Leptomeningitis vs Pachymeningitis
J Comput Assist Tomogr 19:713-720, Kioumehr,F.,et al, 1995
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Article Abstract
Thirty of the 83 subjects had carcinomatous,28 infectious,14 reactive,8 chemical and 3 inflammatory etiology for meningitis.Twenty-five cases(83%) of the carcinomatous,14(100%)of the reactive,three(100%)of the inflammatory and 1(12%)of the chemical meningitis subgroups demonstrated pachymeningeal enhancement,while 28 cases(100%)of the infectious meningitis and 7(78%)of the chemical meningitis subgroups had leptomeningeal enhancement.Only five cases(17%)of the carcinomatous meningitis subgroup showed leptomeningeal enhancement.Four of these five cases were as a result of direct spread of intraparenchymal tumors or through perineural extension,rather than hematogenous involvement.Only one patient with carcinomatous meningitis demonstrated leptomeningeal enhancement without clear intraparenchymal lesion.The recognition of various patterns of meningeal enhancement(leptomeningitis versus pachymeningitis)may help in differentiating between infectious and carcinomatous meningitis.This study demonstrated that infectious meningitis presents mostly as leptomeningitis,while carcinomatous meningitis presents as pachymeningitis.
 
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anatomy of
chemical meningitis
gadolinium
meningeal enhancement
meninges
meningitis
meningitis,aseptic
meningitis,bacterial
meningitis,carcinomatous
meningitis,fungal
MRI
MRI,abnormal
MRI,contrast enhanced
pachymeningitis,cranial

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