Gd-DTPA enhancement of CSF in meningeal carcinomatosis.
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.
Pui
M H
MH
Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN 38105.
Langston
J W
JW
Arai
Y
Y
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*
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA