Faculty Collaboration Database

Spinal magnetic resonance imaging immediately after craniotomy for detection of metastatic disease. Pediatr Neurosurg 1995;23(4):171-81

Date

01/01/1995

Pubmed ID

8835206

DOI

10.1159/000120955

Scopus ID

2-s2.0-0029616185 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

Although magnetic resonance imaging (MRI) may be more sensitive than myelography with CT scanning in detecting spinal metastatic disease (SMD), the limitations of these MRI examinations have not been defined. The feasibility of obtaining early postoperative MRI to screen for SMD, and the type and frequency of imaging abnormalities were evaluated in this prospective study. Twenty-seven patients (78% with nondisseminating neoplasms or nonneoplastic diseases) were studied with postoperative spinal MRI without and with contrast enhancement, obtained within 24 h of craniotomy. Procedural problems with immediate spinal MRI were identified. Physician monitoring of the examination did not guarantee an adequate examination, and small abnormalities were missed or incompletely evaluated at the time of the MRI. Surprisingly, abnormal signal from intraspinal gas, blood, or blood breakdown products was not seen. In the absence of metastatic disease, spinal meningeal enhancement was absent. True SMD was detected, but nonneoplastic focal contrast enhancement (false positive) occurred in 11%. An unusual nonneoplastic subdural cerebrospinal fluid enhancement was seen in 3 of 13 (23%) of all patients undergoing posterior fossa craniectomies. This enhancement could hide small metastases or could be confused for SMD. Although immediate postoperative spinal MRI is potentially effective as a screening tool for the detection of SMD, we have identified some significant limitations of this technique.

Author List

Kaufman BA, Moran CJ, Park TS

Author

Bruce A. Kaufman MD Adjunct Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Brain
Brain Neoplasms
Child
Child, Preschool
Craniotomy
Female
Humans
Image Enhancement
Infant
Magnetic Resonance Imaging
Male
Meninges
Neoplasm Staging
Prognosis
Sensitivity and Specificity
Spinal Cord
Spinal Cord Neoplasms