Patterns of contrast enhancement in the pediatric spine at MR imaging with single- and triple-dose gadolinium.
OBJECTIVE
To assess patterns of nerve root and spinal cord contrast enhancement in the pediatric spine at magnetic resonance (MR) imaging with single- and triple-dose gadolinium.


METHODS
In three control patients with no suspected pathologic spinal condition and 19 patients with a suspected condition, spinal cords were evaluated prospectively for potential spread of tumor to cerebrospinal fluid ("drop metastases") (n = 18) or Guillain-Barré syndrome (n = 1). After enhancement with 0.1 mmol/kg gadolinium, patients without definite drop metastases (n = 8) received a booster of 0.2 mmol/kg gadolinium 30-40 minutes later; clinical follow-up was obtained 12 1/2 to 19 months later.


RESULTS
Drop metastases appeared as nodular areas of enhancement in 11 patients. Vascular enhancement related to the spinal cord surface and emerging nerve roots was observed in images obtained in all control patients, as well as in patients with negative findings at lumbar puncture and at clinical or MR imaging follow-up examination (n = 6). Vascular and nerve root enhancement increased with triple-dose gadolinium and was greater in patients after radiation therapy (n = 17) than in control patients (n = 3).


CONCLUSIONS
Use of triple-dose gadolinium did not result in detection of additional cases of drop metastases.
Long Beach Memorial MRI Center, CA 90806, USA.
J K
JK
Tam
W G
WG
Bradley
S K
SK
Goergen
D Y
DY
Chen
P J
PJ
Pema
M D
MD
Dubin
L M
LM
Teresi
J E
JE
Jordan
D000293:Adolescent; D000328:Adult; D001808:Blood Vessels / Q000473:pathology; D001932:Brain Neoplasms / Q000473:pathology; D002528:Cerebellar Neoplasms / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage*; D004806:Ependymoma / Q000175:diagnosis / Q000556:secondary; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage; D006571:Heterocyclic Compounds / Q000008:administration & dosage*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000175:diagnosis / Q000556:secondary; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011129:Polyradiculoneuropathy / Q000175:diagnosis; D011446:Prospective Studies; D013116:Spinal Cord / Q000098:blood supply / Q000473:pathology*; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000556:secondary; D013126:Spinal Nerve Roots / Q000473:pathology; D013129:Spinal Puncture
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium