Blews D E, Wang H, Kumar A J, Robb P A, Phillips P C, Bryan R N
Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD.
J Comput Assist Tomogr. 1990 Sep-Oct;14(5):730-5. doi: 10.1097/00004728-199009000-00009.
Recently, the application of intravenous gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) has been shown to improve the detection of intradural extramedullary spinal disease in adults. The ability of Gd-DTPA enhanced magnetic resonance (MR) to detect intradural extramedullary spinal metastases was studied in pediatric brain tumor patients. Spinal MR images before and after intravenous injection of Gd-DTPA were analyzed retrospectively in eight pediatric patients with known intracranial neoplasms and clinically suspected subarachnoid tumor seedings. Contrast enhanced spinal MR was compared with CT myelography in four of these patients. In our pediatric population Gd-DTPA enhanced images revealed tumor seeding not appreciable on noncontrast images. Although CT myelography has been the accepted standard investigation in the evaluation of suspected spinal metastases in children, we found that contrast enhanced MR is equal or superior in sensitivity to CT myelography. Spinal MR also provided information not obtainable via CT myelography. In the future, Gd-DTPA enhanced spinal MR should be considered in the initial evaluation of suspected subarachnoid spinal metastases in pediatric patients with known primary brain tumors.
最近，静脉注射钆喷酸葡胺（Gd-DTPA）已被证明可提高成人硬脊膜内髓外脊髓疾病的检测率。对患有小儿脑肿瘤的患者，研究了Gd-DTPA增强磁共振（MR）检测硬脊膜内髓外脊髓转移瘤的能力。对8例已知颅内肿瘤且临床怀疑有蛛网膜下腔肿瘤播散的小儿患者，回顾性分析静脉注射Gd-DTPA前后的脊髓MR图像。其中4例患者的对比增强脊髓MR与脊髓CT造影进行了比较。在我们的小儿患者群体中，Gd-DTPA增强图像显示出在非增强图像上无法察觉的肿瘤播散。虽然脊髓CT造影一直是评估儿童疑似脊髓转移瘤的公认标准检查方法，但我们发现对比增强MR在敏感性上等同于或优于脊髓CT造影。脊髓MR还提供了脊髓CT造影无法获得的信息。未来，对于已知原发性脑肿瘤的小儿患者，在初步评估疑似蛛网膜下腔脊髓转移瘤时，应考虑使用Gd-DTPA增强脊髓MR。
