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We evaluated 14 consecutive patients with leptomeningeal metastasis prospectively,using both T1-weighted(T1W)gadolinium-DTPA-enhanced MR(Gd- MR)and contrast-enhanced CT(CE-CT).Thirteen had positive CSF cytology;the remaining patient had an atypical CSF lymphocytosis and primary CNS lymphoma.The patients(8M/6F)ranged in age from 8 to 70 years(median,42 years).Tumor histology included 3 systemic and 2 primary CNS lymphomas,3 breast carcinomas,2 leukemias,1 malignant schwannoma,1 small cell lung cancer,1 prostate cancer,and 1 melanoma.Both imaging methods demonstrated parenchymal volume loss equally well in all patients.Gd-MR revealed abnormal enhancement of meninges or parenchyma in 10 patients,including all 5 patients with positive CE-CT.Neither technique revealed any foci of abnormal enhancement in 4 patients.Gd-MR was superior to CE-CT in demonstrating and quantifying enhancing subarachnoid and parenchymal nodules in 6 patients and in demonstrating sulcal,dural,cisternal, tentorial,and ependymal enhancement.Our findings indicate that T1W Gd-MR is the preferred imaging modality in leptomeningeal metastasis and suggest that CE-CT is unnecessary. |
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CAT scan
CAT scan,abnormal
CAT scan,contrast enhanced
cerebrospinal fluid,cytology
gadolinium
lymphoma involving CNS
meningeal enhancement
meninges
meningitis,carcinomatous
meningitis,leukemic
meningitis,lymphomatous
MRI
MRI,abnormal
MRI,CAT scan compared to
MRI,contrast enhanced
neoplasm,metastatic to Dura
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