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Spurious leptomeningeal enhancement on immediate post-operative MRI for paediatric brain tumours
Elysa Widjaja1, Daniel J A Connolly, Sylvia Gatscher
1Department of Radiology, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK. Elysa.Widjaja@sth.nhs.uk
Abstract:
Immediate post-operative MRI has been recommended as an accurate and robust method to assess residual brain tumour. Early enhancement at the resection margin and in the dura is well recognized, but we describe two cases of enhancement in the basal cisterns on immediate post-operative MRI that resolved on follow-up. The underlying cause of the enhancement remains to be elucidated, but it should be recognized that leptomeningeal enhancement may occur after surgery and that this does not necessarily imply tumour spread.
Insights
Immediate post-operative MRI can accurately assess residual brain tumors. However, new findings show basal cistern enhancement on MRI after surgery may not indicate tumor spread and can resolve over time.
Area of Science:
- Neuroimaging
- Neurosurgery
- Neuroradiology
Background:
- Post-operative Magnetic Resonance Imaging (MRI) is crucial for evaluating residual brain tumors.
- Early enhancement at resection margins and dura are common findings.
Observation:
- Two cases presented with unexpected basal cistern enhancement on immediate post-operative MRI.
- This enhancement was transient and resolved on subsequent follow-up scans.
Findings:
- Leptomeningeal enhancement in the basal cisterns can occur transiently after brain surgery.
- The exact cause of this post-operative enhancement is yet to be determined.
Implications:
- Clinicians should be aware that post-surgical leptomeningeal enhancement does not automatically signify tumor recurrence or spread.
- This finding may help prevent misinterpretation of imaging results, reducing unnecessary interventions.
