Neoplastic meningitis MRI: Difference between revisions

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==Overview==
==Overview==
Brain MRI is helpful in the diagnosis of neoplastic meningitis. On MRI, neoplastic meningitis is characterized by normal T1- and T2-weighted images. On contrast administration, there may be leptomeningeal enhancement scattered over the brain in a 'sugar coated' manner, which is fairly diagnostic for neoplastic meningitis.<ref name="eaturesradiographicfneomeningitis1">Radiographic features of leptomeningeal metastases. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningeal-metastases. Accessed on January 19, 2016</ref>


==MRI==
==MRI <ref>{{Cite journal|last=Pellerino|first=Alessia|date=March 2018|title=Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844521/|journal=Therapeutic Advances in Neurological Disorders|volume=11|pages=|via=}}</ref>==
*Brain MRI is helpful in the diagnosis of neoplastic meningitis.  
*Brain MRI is helpful in the diagnosis of neoplastic meningitis with sensitivity and specificity estimated to be around 66-98% and 77-97.7% respectively.
*On MRI, neoplastic meningitis is characterized by:<ref name=eaturesradiographicfneomeningitis1>Radiographic features of leptomeningeal metastases. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningeal-metastases. Accessed on January 19, 2016</ref>
*The most sensitive MRI component are contrast-enhanced T1 weight and fluid attenuated inversion recovery (FLAIR) sequences.
*Findings that are fairly suggestive of neoplastic meningitis include nodular meningeal tumor, meningeal thickening > 3 mm, and a '''subjectively strong''' contrast enhancement. A '''smooth''' contrast enhancement of the meninges is typical for inflammatory, nonneoplastic meningitis.<ref name="dxnm123">Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016</ref>
*On MRI, neoplastic meningitis is characterized by:<ref name="eaturesradiographicfneomeningitis1">Radiographic features of leptomeningeal metastases. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningeal-metastases. Accessed on January 19, 2016</ref>


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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|MRI component}}
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|MRI component}}
! style="background: #4479BA; width: 800px;" | {{fontcolor|#FFF|Findings}}
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T1
T1
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*Usually normal
*Usually normal
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|-
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T2
T2
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*Usually normal
*Usually normal
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T1 with contrast
T1 with contrast
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| style="padding: 5px 5px; background: #F5F5F5;" |
*Leptomeningeal enhancement scattered over the brain in a 'sugar coated' manner
*Leptomeningeal enhancement scattered over the brain in a 'sugar coated' manner (diagnostic)
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|-
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Fluid-attenuated inversion recovery<br>(FLAIR)
Fluid-attenuated inversion recovery<br>(FLAIR)
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Latest revision as of 23:10, 28 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Brain MRI is helpful in the diagnosis of neoplastic meningitis. On MRI, neoplastic meningitis is characterized by normal T1- and T2-weighted images. On contrast administration, there may be leptomeningeal enhancement scattered over the brain in a 'sugar coated' manner, which is fairly diagnostic for neoplastic meningitis.[1]

MRI [2]

  • Brain MRI is helpful in the diagnosis of neoplastic meningitis with sensitivity and specificity estimated to be around 66-98% and 77-97.7% respectively.
  • The most sensitive MRI component are contrast-enhanced T1 weight and fluid attenuated inversion recovery (FLAIR) sequences.
  • Findings that are fairly suggestive of neoplastic meningitis include nodular meningeal tumor, meningeal thickening > 3 mm, and a subjectively strong contrast enhancement. A smooth contrast enhancement of the meninges is typical for inflammatory, nonneoplastic meningitis.[3]
  • On MRI, neoplastic meningitis is characterized by:[1]
MRI component Findings

T1

  • Usually normal

T2

  • Usually normal

T1 with contrast

  • Leptomeningeal enhancement scattered over the brain in a 'sugar coated' manner (diagnostic)

Fluid-attenuated inversion recovery
(FLAIR)

  • Abnormally elevated signal within sulci

References

  1. ↑ 1.0 1.1 Radiographic features of leptomeningeal metastases. Dr Bruno Di Muzio and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/leptomeningeal-metastases. Accessed on January 19, 2016
  2. ↑ Pellerino, Alessia (March 2018). "Neoplastic meningitis in solid tumors: from diagnosis to personalized treatments". Therapeutic Advances in Neurological Disorders. 11.
  3. ↑ Diagnosis of neoplastic meningitis. Wikipedia 2016. https://en.wikipedia.org/wiki/Neoplastic_meningitis. Accessed on January 20, 2016


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