title: Cranial Pachymeningeal Involvement in POEMS Syndrome: Evaluation by Pre- and Post-contrast FLAIR and T1-weighted Imaging.
abstract: OBJECTIVE
  To evaluate the cranial pachymeningeal involvement of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome using pre- and post-contrast fluid-attenuated inversion recovery (FLAIR) and T1-weighted imaging (T1WI).
  
  
  METHODS
  The appearance of pachymeningeal involvement in nine cases of POEMS syndrome was evaluated using pre- and post-contrast FLAIR and T1WI. The degree of pachymeningeal thickening was graded as normal or abnormal using pre-contrast FLAIR. The degrees of contrast enhancement effect were evaluated based on pre- and post-contrast images, and recorded in each of three separate anatomical areas, i.e., the falx cerebri, cerebral convexity, and tentorium cerebelli. The degrees of contrast enhancement of pachymeninges were graded as not detected (ND), positive, or prominent on post-contrast FLAIR, and normal range (NR), positive, and prominent on post-contrast T1WI.
  
  
  RESULTS
  Pre-contrast FLAIR demonstrated 41% of pachymeningeal anatomical regions as areas of thickening. Post-contrast FLAIR did not detect any contrast enhancement on 26% of the regions but showed positive enhancement on 30% and prominent enhancement on 44%. Post-contrast T1WI showed normal range enhancement on 48%, positive enhancement on 11%, and prominent enhancement on 41% of the regions. Post-contrast FLAIR showed the highest percentage for detection of pachymeningeal abnormalities (74%).
  
  
  CONCLUSIONS
  Post-contrast FLAIR may contribute to objective judgment in the evaluation of pachymeningeal involvement in POEMS syndrome.
authors.affiliation: Department of Advanced Medical Imaging, Graduate School of Medical Science, Kanazawa University.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Ueda
authors.affiliation: Department of Radiology, Kanazawa University Hospital.
authors.forename: Miho
authors.initials: M
authors.lastname: Okuda
authors.affiliation: Department of Radiology, Kanazawa University Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Aburano
authors.affiliation: Department of Radiology, Kanazawa University Hospital.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yoshie
authors.affiliation: Department of Advanced Medical Imaging, Graduate School of Medical Science, Kanazawa University.
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
authors.affiliation: Department of Radiology, Kanazawa University Hospital.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Gabata
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D004388:Dura Mater / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000000981:diagnostic imaging*
keywords: FLAIR; POEMS syndrome; contrast enhancement; magnetic resonance imaging; pachymeninges