Diseases of the intracranial meninges: MR imaging features.

Sze, G

doi:10.2214/ajr.160.4.8456653

Cited by 57 publications

(36 citation statements)

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“…When water accumulates within the dura mater, contrast enhancement can occur [17]. It is well known that various benign or malignant conditions, including intracranial hypotension, granulomatous disease, and metastatic disease can be associated with dural enhancement on contrast-enhanced T1-weighted MR images [17], [18]. In addition, many prior studies have demonstrated that patients who have undergone intracranial surgery show postoperative dural enhancement [19] [19]–[23].…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced FLAIR (Fluid-Attenuated Inversion Recovery) for Evaluating Mild Traumatic Brain Injury

et al. 2014

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PurposeTo evaluate whether adding a contrast-enhanced fluid-attenuated inversion recovery (FLAIR) sequence to routine magnetic resonance imaging (MRI) can detect additional abnormalities in the brains of symptomatic patients with mild traumatic brain injury.Materials and MethodsFifty-four patients with persistent symptoms following mild closed head injury were included in our retrospective study (M∶F = 32∶22, mean age: 59.8±16.4, age range: 26–84 years). All MRI examinations were obtained within 14 days after head trauma (mean: 3.2±4.1 days, range: 0.2–14 days). Two neuroradiologists recorded (1) the presence of traumatic brain lesions on MR images with and without contrast-enhanced FLAIR images and (2) the pattern and location of meningeal enhancement depicted on contrast-enhanced FLAIR images. The number of additional traumatic brain lesions diagnosed with contrast-enhanced FLAIR was recorded. Correlations between meningeal enhancement and clinical findings were also evaluated.ResultsTraumatic brain lesions were detected on routine image sequences in 25 patients. Three additional cases of brain abnormality were detected with the contrast-enhanced FLAIR images. Meningeal enhancement was identified on contrast-enhanced FLAIR images in 9 cases while the other routine image sequences showed no findings of traumatic brain injury. Overall, the additional contrast-enhanced FLAIR images revealed more extensive abnormalities than routine imaging in 37 cases (p<0.001). In multivariate logistic regression analysis, subdural hematoma and posttraumatic loss of consciousness showed a significant association with meningeal enhancement on contrast-enhanced FLAIR images, with odds ratios 13.068 (95% confidence interval 2.037 to 83.852), and 15.487 (95% confidence interval 2.545 to 94.228), respectively.ConclusionMeningeal enhancement on contrast-enhanced FLAIR images can help detect traumatic brain lesions as well as additional abnormalities not identified on routine unenhanced MRI. Therefore contrast-enhanced FLAIR MR imaging is recommended when a contrast MR study is indicated in a patient with a symptomatic prior closed mild head injury.

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Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced FLAIR (Fluid-Attenuated Inversion Recovery) for Evaluating Mild Traumatic Brain Injury

et al. 2014

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“…Both layers of the pia-arachnoid have tight junctions within the capillaries and therefore, leptomeningeal enhancement is normally not seen or it is subtle following contrast administration for either MR or CT (9,10). Diffuse or widespread multifocal nodular enhancement and thickened leptomeninges are the typical finding of leptomineningeal metastasis on the postcontrast MR imaging (11,12). However, this could also represent a non-tumorous condition such as granulomatous infection (13).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Intraspinal Enhancement for Medulloblastoma on MR Imaging

Kim

et al. 2004

J Korean Radiol Soc

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Purpose: The purpose of this study was to analyze the enhancement pattern of the spinal cord for patients with medulloblastoma, and to correlate the enhancement pattern with cerebrospinal fluid (CSF) tumor seeding. Materials and Methods:We retrospectively reviewed 84 MR images, including the initial and follow-up studies after chemotherapy or radiation therapy, of 25 patients with medulloblastoma who were aged from 2 to 13 years. We analyzed the spinal leptomeningeal enhancement pattern on the MR images. The leptomeningeal enhancement patterns were categorized into three types: Type I, fine or discontinuous linear enhancement, and type II, continuous linear or nodular enhancement, and type III, intradural mass formation. We correlated the enhancement pattern on MRI with the results of CSF cytology at the initial and follow -up examinations after treatment. Results: Of total 25 patients, type I enhancement was observed for 14 patients. Twelve patients were negative on the initial CSF cytology and 2 patients were positive. On the follow-up MR studies, 14 patients showed no change or only a slight decrease of enhancement, and all were negative on the follow-up CSF cytology. Type II enhancement patterns were observed in seven patients, and all of them were positive on the initial CSF cytology. On follow-up MR study, one patient revealed an increased enhancement with the positive result on the follow-up CSF cytology, and six patients had decreased enhancement on the follow-up MR studies with negative conversion on the follow-up CSF cytology. Type III enhancement patterns were observed in four patients and all of them were positive on the initial CSF cytology. All four patients with intradural mass formations revealed progression of the lesions on follow-up MR studies, and all of them were positive on the follow-up CSF cytology. Conclusion: Type II and III enhancement patterns always represented CSF seeding and a type I enhancement pattern had a low probability of metastasis.

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“…It is known that meningeal carcinomatosis is a late complication of lung cancer in 10% of patients. 13 Fifty-two percent of lung cancer patients have a neurologic complication at the time of diagnosis. 13 CES may be an isolated presentation of meningeal carcinomatosis.…”

Section: Discussionmentioning

confidence: 99%

“…13 Fifty-two percent of lung cancer patients have a neurologic complication at the time of diagnosis. 13 CES may be an isolated presentation of meningeal carcinomatosis. 9 The prognosis is poor.…”

Section: Discussionmentioning

confidence: 99%