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- W2608068926 abstract "Background: Abnormal contrast enhancement and thickening of the cerebral meninges in MRI is frequent in, but not exclusively characteristic for neoplastic meningitis (NM). The introduction of contrast enhanced (CE) mp-rage sequences into routine MR-imaging resulted in a more prominent appearence of the meninges. We asked here if the visual assessment of meningeal thickening by the radiologist is reproducible by measurement in imaging software, and if this radiological parameter is suitable to distinguish between conditions and diseases affecting the meninges. Methods: The reports on approx. 7500 MRI examinations were scanned for the terms “meninges” and “thick” or “enlarged”. 298 cases could be detected, of which 108 could be completely analysed with the radiological “PACS” analysis software and clinical records were available for analysis. The diameter of the meninges in coronal orientation of CE T1 or CE mp-rage sequences were measured with the integrated measurement tool at the level of the Sylvian fissure and in axial orientation at the central sulcus bilaterally. For comparison, 121 cases with normal appearing meninges were assessed accordingly. The intraindividual reliability was analysed with a second measurement of 39 cases after 2 months. The clinical records of the patients were reviewed to recognise the underlying diseases. Results: The diameters of the meninges differed significantly (p<0,001) between normal and pathological appearing cases: the mp-rage mean coronal diameter was dextral 2,21mm (SD 0,415, N=88) vs. control 1,44 (SD 0,188, N=121); the mp-rage mean axial diameter sinistral was 2,13 (SD 0,683, N=88) vs. control 1,49 (SD 0,184, N=106). The variability of the measurements, however, was relatively high (range from 1,3mm to 7,5mm over all locations). Underlying diseases were neoplastic, such as neoplastic meningitis (n=16), but also solid metastases without CSF involvement (n=7); inflammatory diseases like bacterial and viral meningitis (n=14); mechanic alterations like trepanation (n=42), previous lumbar puncture (n=11) and low CSF pressure syndrome (n=4; rare conditions not given). Conclusion: Not only neoplastic meningitis, but also a number of other diseases and conditions such as inflammation or alterations of CSF pressure can cause thickening of the leptomeninges and should be considered as differential diagnoses. Measurement of the meningeal diameter with the routine radiological analysis software is feasible for achieving numeric values that distinguish significantly between normal and abnormal meningeal thickness. The intraindividual variability of the measurements, however, was higher than expected." @default.
- W2608068926 created "2017-05-05" @default.
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- W2608068926 date "2017-04-01" @default.
- W2608068926 modified "2023-09-26" @default.
- W2608068926 title "P14.23 Thickening of cerebral meninges - a proof of neoplastic meningitis?" @default.
- W2608068926 doi "https://doi.org/10.1093/neuonc/nox036.408" @default.
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