Gd-DTPA-enhanced MR imaging of leptomeningeal spread of primary intracranial CNS tumor in children

Three children with known primary brain neoplasms and leptomeningeal disease were evaluated with MR imaging. Two of the patients had medulloblastoma and one had pineoblastoma. The presence of leptomeningeal tumor spread was established by positive CSF cytopathology in conjunction with compatible contrast-enhanced CT findings. Contrast-enhanced CT, nonenhanced MR, and Gd-DTPA-enhanced MR studies were then compared. In two cases, leptomeningeal lesions were seen better with Gd-DTPA-enhanced MR than with contrast-enhanced CT. In all three cases, Gd-DTPA MR imaging revealed lesions that were not identified on noncontrast MR. Gd-DTPA-enhanced MR imaging is useful when searching for intracranial leptomeningeal tumor deposits in pediatric patients at risk for this condition.