Evaluation of the Intraspinal Enhancement for Medulloblastoma on MR Imaging.
10.3348/jkrs.2004.51.4.459
- Author:
Hwa Young KIM
1
;
In One KIM
;
Woo Sun KIM
;
Jung Eun CHEON
;
Kyung Mo YEON
Author Information
1. Department of Radiology and Institute of Radiation Medicine, MRC Seoul National University College of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Brain neoplasms;
Brain neoplasms, metabolism;
Brain, MR;
Spine, MR
- MeSH:
Brain Neoplasms;
Cerebrospinal Fluid;
Drug Therapy;
Follow-Up Studies;
Humans;
Magnetic Resonance Imaging*;
Medulloblastoma*;
Neoplasm Metastasis;
Retrospective Studies;
Spinal Cord
- From:Journal of the Korean Radiological Society
2004;51(4):459-464
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
