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Gadolinium DTPA(Gd-DTPA)is a paramagnetic blood-brain barrier contrast agent for MRI that has been used primarily in adults.During May through October 1987,17 children between the ages of 3 and 18 years with brain tumors underwent MRI examinations,before and after Gd-DTPA(11 gliomas,4 medulloblastomas,1 craniopharyngioma,and 1 child with neurofibromatosis and no pathologic diagnosis).We compared T1 and T2 Gd-DTPA-enhanced MRI with concurrent unenhanced MRI and enhanced CT,and then correlated this with the clinical and pathologic findings.GD-DTPA-enhanced tumors in all 7 patients with newly diagnosed tumors and enhanced tumors in 7 to 10 patients,without clinical evidence of progressive disease at the time of the study.In the 7 new patients,Gd-DTPA defined tumor margins in all,and demonstrated internal tumor architecture(vessels,necrosis,and cysts)in 5. Areas believed to represent surgical scars showed varying degrees of enhancement.Leptomeningeal tumor spread,including spinal,not seen on pre- Gd-DTPA MRI or on contrast CT,was evident 2 patients.Gd-DTPA enhancement obscured hemorrhage within the tumor(methemoglobin)in 2 patients.There were no significant side effects.These results suggest that Gd-DPTA- enhanced MRI(1)is safe in children,(2)demonstrates the extent and character of tumors better than unenhanced MRI and enhanced CT,and(3)may allow for noninvasive imaging of leptomeningeal disease,including the spine,not previously demonstrated by any other noninvasive neuroimaging technique. |
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gadolinium
glioma
meningeal gliomatosis
MRI
MRI,abnormal
MRI,brain tumors
MRI,CAT scan compared to
MRI,contrast enhanced
MRI,contrast enhanced,postoperative
neoplasm,primary intracranial
neoplasm,primary of CNS
neoplasm,primary of CNS-children
neoplasm,primary of CNS-intraventricular
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