Aims: To compare unenhanced, gadolinium enhanced, delayed gadolinium enhanced FLAIR images, gadolinium enhanced and delayed gadolinium enhanced T1 images in different types of leptomeningeal diseases, and to determine the most accurate MRI sequence for the diagnosis of leptomeningeal disease.
Material: and methods: Ten patients (6 men, 4 women, age: 52,7+/-16,4) clinically suspected of cerebral leptomeningeal infectious or tumoral disease underwent brain MR examination: Axial FLAIR and T1 SE images were acquired before, immediately after administration of gadobenate dimeglumine (0.1 mmol per kilogram of body weight) (early enhancement), and 20 minutes after injection of contrast media (delayed enhancement). Images were analysed to determine the more appropriate technique for the diagnosis of leptomeningeal disease.
Results: Early enhanced FLAIR and delayed enhanced T1 were always more or equally accurate for the diagnosis of leptomeningeal diasease, as compared to, respectively, unenhanced FLAIR and early enhanced T1 images Delayed enhanced FLAIR was always more accurate for the diagnosis of leptomeningeal disease as compared to early enhanced FLAIR images. Delayed enhanced FLAIR was in most of the cases more accurate for the diagnosis of leptomeningeal disease as compared to delayed enhanced T1 images.
Conclusion: Delayed enhanced FLAIR MR sequence seems to improve the diagnosis of leptomeningeal infectious or tumoral diseases as compared to other MR sequences.
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http://dx.doi.org/10.1016/s0150-9861(06)77286-8 | DOI Listing |
Adv Radiat Oncol
February 2025
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Purpose: Treatment options for leptomeningeal metastasis (LM) are limited. A recent phase 2 study found that proton craniospinal irradiation (pCSI) was well-tolerated and improved survival. We report our experience with pCSI for solid-tumor LM.
View Article and Find Full Text PDFCancers (Basel)
January 2025
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94304, USA.
Background: Leptomeningeal disease (LMD) from cancer indicates advanced cancer and can lead to obstructive hydrocephalus, for which palliative cerebrospinal fluid (CSF) diversion may be indicated to alleviate symptoms. We investigated surgical outcomes for hydrocephalus for adult patients with LMD and conducted a systematic review on pediatric and adult cases.
Methods: We analyzed outcomes from a 10-year period of patients with neoplastic LMD, obstructive hydrocephalus, and documented date of death.
Children (Basel)
January 2025
Department of Neuroradiology, University Hospital Würzburg, D-97080 Würzburg, Germany.
Background: Intracranial choroid plexus tumors (CPT) are rare and primarily affect young children. Leptomeningeal dissemination (LMD) has been reported not only in high-grade choroid plexus carcinoma (CPC) but also in lower histological grades; however, a systematic evaluation of CPT-specific imaging characteristics remains lacking.
Methods: We analyzed the imaging characteristics of LMD in a single-center pediatric cohort of 22 CPT patients (thirteen choroid plexus papilloma (CPP), six atypical choroid plexus papilloma (aCPP), three CPC), comparing LMD features with those of the primary tumor.
Clin Nucl Med
January 2025
From the Department of Nuclear Medicine, University of Health Sciences, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.
Neoplastic meningitis, also known as leptomeningeal metastases, is a rare clinical entity seen in less than 1%-2% of primary nervous system tumors. Diagnosis of leptomeningeal metastases is difficult and is achieved by cytologic evidence of malignant cells in cerebrospinal fluid, or demonstration of radiologic abnormality. 18F-FDG PET/CT can detect leptomeningeal metastases before anatomical changes.
View Article and Find Full Text PDFChilds Nerv Syst
January 2025
The Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Background: Atypical teratoid/rhabdoid tumours (ATRTs) are malignant central nervous system tumours, typically presenting in the posterior fossa of very young children. Prognosis remains poor despite current therapy, while tumorigenesis implicates both genomic and epigenetic dysregulation. Primary diffuse leptomeningeal (PDL) ATRT, characterised by the absence of an intraparenchymal mass lesion, is seldom reported but appears associated with a dismal outcome.
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