Intravenous contrast in spinal computed tomography to identify epidural metastases

In 16 patients with spinal epidural metastases from various neoplasms the usefulness of intravenous (IV) contrast injection in spinal computed tomography (CT) scanning was analyzed for determining the presence and extent of the epidural lesion. In all cases enhancement of the epidural tumor mass occurred, which effectively showed the outline of the lesion. The extent of the epidural metastases in the spinal canal was equally well visualized as by myelography. Compared to spinal CT scanning without contrast administration, all IV contrast enhanced CT scans were clearly superior in demonstrating epidural metastases. Intravenous contrast in spinal CT-scanning appears to add relevant information and seems a useful and simple method to define the extent of the epidural tumor. It should be considered in patients where myelography is contraindicated and it may be a valuable method when the response of the epidural tumor to treatment must be determined.