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Drop metastases to the pediatric spine revealed with diffusion-weighted MR imaging

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Abstract

Identifying drop metastases to the spine from pediatric brain tumors is crucial to treatment and prognosis. MRI is currently the gold standard for identifying drop metastases, more sensitive than CSF cytology, but imaging is not uncommonly inconclusive. Although diffusion‐weighted imaging (DWI) of the brain is very useful in the evaluation of hypercellular tumors, DWI of the spine has not been clinically useful in children because of susceptibility artifacts and lack of spatial resolution. A new technique, readout-segmented echo planar imaging (EPI), has improved these images, allowing for identification of hypercellular drop metastases. We report a case that illustrates the utility of spine DWI in the detection of metastatic disease in children with primary central nervous system (CNS) tumors. This case suggests that DWI of the spine with readout-segmented EPI should be included in the evaluation for drop metastases.

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Acknowledgement

We are grateful to Thorsten Feiweier of Siemens Healthcare, Erlangen, Germany, for providing the diffusion-encoding module used in this study.

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Authors and Affiliations

  1. Department of Radiology, Children’s Healthcare of Atlanta at Scottish Rite, 1001 Johnson Ferry Road NE, Atlanta, GA, 30342, USA

    Laura L. Hayes, Richard A. Jones & Susan Palasis

  2. Department of Radiology, Emory University, Atlanta, GA, USA

    Richard A. Jones

  3. Aflac Cancer Center and Blood Disorder Services, Children’s Health Care of Atlanta, Emory University School of Medicine, Atlanta, GA, USA

    Dolly Aguilera

  4. Siemens AG, Healthcare Sector, Erlangen, Germany

    David A. Porter

Authors
  1. Laura L. Hayes
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  2. Richard A. Jones
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  3. Susan Palasis
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  4. Dolly Aguilera
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  5. David A. Porter
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Corresponding author

Correspondence to Laura L. Hayes.

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Hayes, L.L., Jones, R.A., Palasis, S. et al. Drop metastases to the pediatric spine revealed with diffusion-weighted MR imaging. Pediatr Radiol 42, 1009–1013 (2012). https://doi.org/10.1007/s00247-011-2295-9

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  • DOI: https://doi.org/10.1007/s00247-011-2295-9

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