Focal leptomeningeal vascular anomalies on brain MRI: A mimic of leptomeningeal metastatic disease.

Autor:	Boutet A; Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada., Malik M; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Yang AZ; Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Germann J; Krembil Brain Institute, Toronto, Ontario, Canada.; Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Haile SS; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Son HJ; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Vetkas A; Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Pai V; Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.; Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada., Mason WP; Department of Medicine, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., Zadeh G; Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada., Mandell DM; Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Neuro-oncology practice [Neurooncol Pract] 2024 Jun 07; Vol. 11 (6), pp. 772-778. Date of Electronic Publication: 2024 Jun 07 (Print Publication: 2024).
DOI:	10.1093/nop/npae050
Abstrakt:	Background: The diagnosis of leptomeningeal metastatic disease has major prognostic and therapeutic implications. We report 13 patients with a radiologically distinct kind of focal, enhancing leptomeningeal lesion on brain MRI that mimics leptomeningeal metastatic disease. Methods: These patients were assessed at University Health Network (Toronto, Canada) between January 2001 and December 2023. Results: Median age was 68 years (range, 55-78 years) and 10 patients were women. All patients had brain magnetic resonance imaging (MRI) including contrast-enhanced T2-weighted fluid attenuation inversion recovery (FLAIR) and T1-weighted spin echo sequences. MRI in all 13 patients showed a focal enhancing lesion located along the leptomeningeal surface of the brain. The MRI exams were reported as possible or likely leptomeningeal metastatic disease for the majority (9/13) of patients. Each lesion was curvilinear rather than sheet-like, and some lesions consisted of multiple connected/branching curvilinear structures with the appearance of abnormal vessels. The lesions were distinct from normal blood vessels. Some lesions had a visible connection with a nearby cortical vein. Follow-up contrast-enhanced brain MRI for 8/13 (62%) patients at a median of 3.9 years (IQR 2.4-6.6 years) showed all lesions were unchanged over time. Another 2/13 (15%) patients had clinical and CT brain follow-up after one year with no evidence of metastatic disease. Conclusions: We describe a distinct kind of focal, enhancing leptomeningeal lesion on brain MRI that mimics metastatic disease. These lesions are likely a type of low-flow vascular anomaly. Their curvilinear/branching shape and intense enhancement particularly on T2-weighted FLAIR images distinguish these lesions from tumors. Competing Interests: None declared. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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