NeuroradiologyCarcinomatous meningitis
(also called meningeal carcinomatosis), metastatic
tumour spread in the dura, the leptomeninges or both. When only the dura is involved the most appropriate definition is that of pachymeningeal carcinomatosis (see
carcinomatosis pachymeningeal).
The dura may be diffusely and homogeneously infiltrated, or nodular masses may be present. Usually the dura is involved together with the skull bone. Marked enhancement is seen following contrast injection. Leptomeningeal carcinomatous meningitis appears as thin linear enhancement along the cortical surface, rarely with nodules. Enhancement usually follows the gyral pattern of the cortex. In the spinal subarachnoid space CSF seeding may lead to collection of cells with a solid nodular appearance in the region of the cauda.
MR with contrast injection is the modality of choice to demonstrate meningeal seeding.
GS