title: Gd-DTPA enhancement of CSF in meningeal carcinomatosis.
abstract: OBJECTIVE
  We report four cases of CSF enhancement secondary to meningeal carcinomatosis observed during MRI. Only one case has been reported previously.
  
  
  METHODS
  Four patients ranging from 4 to 20 years of age, and all having primary or secondary CNS neoplasms, were examined by cranial and/or spinal MRI before and after Gd-DTPA administration. Three of the patients had additional delayed imaging, and subtraction was used in one case.
  
  
  RESULTS
  All four patients demonstrated CSF enhancement after Gd-DTPA administration, which increased on delayed imaging and was more apparent following subtraction. Three of the four patients died within 5 months of the MRI examination.
  
  
  CONCLUSIONS
  CSF enhancement is uncommon, but when seen indicates massive tumor that coats the surface of the CNS. Detection of CNS enhancement may alter therapy; however prognosis may be poor when CSF enhancement is present. Delayed imaging and subtraction may improve detection of CSF enhancement.
authors.affiliation: Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN 38105.
authors.forename: M H
authors.initials: MH
authors.lastname: Pui
authors.forename: J W
authors.initials: JW
authors.lastname: Langston
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
mesh_terms: D000328:Adult; D002555:Cerebrospinal Fluid; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA