Metastatic Extra‐Axial Neoplasia

Annette O. Nusbaum1, Scott W. Atlas2

1 New York Presbyterian Hospital, New York, New York, 2 Stanford University Medical Center, Stanford, California
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A3.2
DOI:  10.1002/0471142719.mia0302s00
Online Posting Date:  May, 2001
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Abstract

There are a multitude of tumors that may spread to the extra‐axial compartment (i.e., meninges, skull base, and calvarium). The role of imaging in the search for metastases is to detect the full extent of and to correctly localize the disease. This unit presents basic protocols for imaging extra‐axial metastatic tumors. Specific modifications are discussed where necessary. The sequences described in this unit are based on a 1.5 T scanner (Echospeed GE Medical Systems, Milwaukee, Wisconsin), but can be expected to be equally applicable to other field strengths and scanners from other manufacturers.

     
 
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Table of Contents

  • Basic Protocol 1: Rule Out (R/O) Leptomeningeal Carcinomatosis
  • Basic Protocol 2: R/O Base of Skull Metastasis
  • Basic Protocol 3: R/O Hemorrhagic Metastatic Disease/melanoma
  • Commentary
  • Literature Cited
  • Tables
     
 
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Materials

Basic Protocol 1: Rule Out (R/O) Leptomeningeal Carcinomatosis

  Materials
  • Normal saline (0.9% NaCl), sterile
  • Intravenous contrast agent (e.g., Magnevist, Omniscan, or Prohance)
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Figures

Videos

Literature Cited

Literature Cited
   Atlas, S.W., Grossman, R.I., Gomori, J.M., Guerry, D., Hackney, D.B., Goldberg, H.I., Zimmerman, R.A., and Bilaniuk, L.T. 1987. MR imaging of intracranial metastatic melanoma. J. Comput. Assist. Tomogr. 11:577‐582.
   Atlas, S.W., Mark, A.S., Grossman, R.I., and Gomori, J.M. 1988. Intracranial hemorrhage: Gradient‐echo MR imaging at 1.5 T. Radiology 168:803‐807.
   Goldberg, H.I., Lavi, E., and Atlas, S.W. 1996. Extra‐axial brain tumors. In Magnetic Resonance Imaging of the Brain and Spine (S.W. Atlas, ed.). Lippincott‐Raven, Philadelphia.
   Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott‐Raven, Philadelphia.
   Singer, M.B., Atlas, S.W., and Drayer, B.P. 1998. Subarachnoid space disease: Diagnosis with fluid‐attenuated inversion‐recovery MR imaging and comparison with gadolinium‐enhanced spin echo MR imaging: Blinded reader study. Radiology 208:417‐422.
   Thulborn, K.R. and Atlas, S.W. 1996. Intracranial hemorrhage. In Magnetic Resonance Imaging of the Brain and Spine, 2nd ed. (S.W. Atlas, ed.). Lippincott‐Raven, Philadelphia.
   Thulborn, K.R., Sorensen, A.G., Kowall, N.W., McKee, A., Lai, A., McKinstry, R.C., Moore, J., Rosen, B.R., and Brady, T.J. 1990. The role of ferritin and hemosiderin in the MR appearance of cerebral hemorrhage: A histopathologic biochemical study in rats. Am. J. Neuroradiol. 11:291‐297.
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