Intradural spinal metastases in pediatric patients with primary intracranial neoplasms: Gd-DTPA enhanced MR vs CT myelography.
Recently, the application of intravenous gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) has been shown to improve the detection of intradural extramedullary spinal disease in adults. The ability of Gd-DTPA enhanced magnetic resonance (MR) to detect intradural extramedullary spinal metastases was studied in pediatric brain tumor patients. Spinal MR images before and after intravenous injection of Gd-DTPA were analyzed retrospectively in eight pediatric patients with known intracranial neoplasms and clinically suspected subarachnoid tumor seedings. Contrast enhanced spinal MR was compared with CT myelography in four of these patients. In our pediatric population Gd-DTPA enhanced images revealed tumor seeding not appreciable on noncontrast images. Although CT myelography has been the accepted standard investigation in the evaluation of suspected spinal metastases in children, we found that contrast enhanced MR is equal or superior in sensitivity to CT myelography. Spinal MR also provided information not obtainable via CT myelography. In the future, Gd-DTPA enhanced spinal MR should be considered in the initial evaluation of suspected subarachnoid spinal metastases in pediatric patients with known primary brain tumors.
Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD.
D E
DE
Blews
H
H
Wang
A J
AJ
Kumar
P A
PA
Robb
P C
PC
Phillips
R N
RN
Bryan
D000293:Adolescent; D001932:Brain Neoplasms; D002648:Child; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography; D009942:Organometallic Compounds; D004369:Pentetic Acid; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA