Gd-DTPA enhancement of CSF in meningeal carcinomatosis

J Comput Assist Tomogr. Nov-Dec 1993;17(6):940-4. doi: 10.1097/00004728-199311000-00016.

Abstract

Objective: We report four cases of CSF enhancement secondary to meningeal carcinomatosis observed during MRI. Only one case has been reported previously.

Materials and 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.

Conclusion: 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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cerebrospinal Fluid*
  • Child
  • Child, Preschool
  • Contrast Media*
  • Female
  • Gadolinium DTPA
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Meningeal Neoplasms / diagnosis*
  • Meningeal Neoplasms / secondary*
  • Organometallic Compounds*
  • Pentetic Acid / analogs & derivatives*

Substances

  • Contrast Media
  • Organometallic Compounds
  • Pentetic Acid
  • Gadolinium DTPA