TY - JOUR
T1 - Most common sites on MRI of intracranial neoplastic leptomeningeal disease
AU - Debnam, J. Matthew
AU - Mayer, Rory R.
AU - Chi, T. Linda
AU - Ketonen, Leena
AU - Weinberg, Jeffrey S.
AU - Wei, Wei
AU - Groves, Morris D.
AU - Guha-Thakurta, Nandita
N1 - Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/11
Y1 - 2017/11
N2 - Neoplastic leptomeningeal disease (LMD) represents infiltration of the leptomeninges by tumor cells. Knowledge of the frequencies of locations of LMD on MRI may assist in early detection, help elucidate the process of leptomeningeal spread of cancer and understand how LMD affects the central nervous system. Our goal was to identify intracranial sites of neoplastic LMD predilection on MRI in patients with cytologically-proven LMD. The presence of FLAIR signal hyperintensity and T1-weighted post-contrast enhancement in the sulci of the supratentorial compartment and cerebellum and enhancement of the cranial nerves (CNs), basal cisterns, pituitary stalk, and ependymal surface of the lateral ventricles, as well as the presence of parenchymal metastasis were recorded. Within each imaging sequence, sites were ordered by prevalence and compared using McNemar's test. The study included 270 patients. Positive MRI findings were present in 185/270 (68.5%) patients. FLAIR signal hyperintensity was significantly more common (p ≤ 0.003) in the cerebellum (n = 96) and occipital lobe (n = 92) relative to the other lobes. Leptomeningeal enhancement was also significantly more common (p ≤ 0.009) in the cerebellum (n = 82) and occipital lobe (n = 67) relative to the other lobes. Enhancement was most commonly found involving CN VII/VIII and the ependymal surface of the lateral ventricles compared to other sites. Parenchymal metastases were present in 110 (40.1%) of the patients. In conclusion, neoplastic LMD predominantly involves the cerebellum and occipital lobes, CN VII/VIII, and the ependymal lining of the lateral ventricles. Parenchymal metastases are frequently present in patients with neoplastic LMD.
AB - Neoplastic leptomeningeal disease (LMD) represents infiltration of the leptomeninges by tumor cells. Knowledge of the frequencies of locations of LMD on MRI may assist in early detection, help elucidate the process of leptomeningeal spread of cancer and understand how LMD affects the central nervous system. Our goal was to identify intracranial sites of neoplastic LMD predilection on MRI in patients with cytologically-proven LMD. The presence of FLAIR signal hyperintensity and T1-weighted post-contrast enhancement in the sulci of the supratentorial compartment and cerebellum and enhancement of the cranial nerves (CNs), basal cisterns, pituitary stalk, and ependymal surface of the lateral ventricles, as well as the presence of parenchymal metastasis were recorded. Within each imaging sequence, sites were ordered by prevalence and compared using McNemar's test. The study included 270 patients. Positive MRI findings were present in 185/270 (68.5%) patients. FLAIR signal hyperintensity was significantly more common (p ≤ 0.003) in the cerebellum (n = 96) and occipital lobe (n = 92) relative to the other lobes. Leptomeningeal enhancement was also significantly more common (p ≤ 0.009) in the cerebellum (n = 82) and occipital lobe (n = 67) relative to the other lobes. Enhancement was most commonly found involving CN VII/VIII and the ependymal surface of the lateral ventricles compared to other sites. Parenchymal metastases were present in 110 (40.1%) of the patients. In conclusion, neoplastic LMD predominantly involves the cerebellum and occipital lobes, CN VII/VIII, and the ependymal lining of the lateral ventricles. Parenchymal metastases are frequently present in patients with neoplastic LMD.
KW - Brain
KW - Cranial nerves
KW - Leptomeningeal disease
KW - Magnetic resonance imaging
KW - Neoplasia
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U2 - 10.1016/j.jocn.2017.07.020
DO - 10.1016/j.jocn.2017.07.020
M3 - Article
C2 - 28802798
AN - SCOPUS:85027220939
SN - 0967-5868
VL - 45
SP - 252
EP - 256
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
ER -