PATTERNS OF CONTRAST ENHANCEMENT IN THE PEDIATRIC SPINE AT MR-IMAGINGWITH SINGLE-DOSE AND TRIPLE-DOSE GADOLINIUM

PURPOSE: To assess patterns of nerve root and spinal cord contrast enh ancement in the pediatric spine at magnetic resonance (MR) imaging wit h single-and triple-dose gadolinium. MATERIALS AND METHODS: In three c ontrol patients with no suspected pathologic spinal condition and 19 p atients with a suspected condition, spinal cords were evaluated prospe ctively for potential spread of tumor to cerebrospinal fluid (''drop m etastases'') (n = 18) or Guillain-Barre syndrome (n = 1). After enhanc ement with 0.1 mmol/kg gadolinium,patients without definite drop metas tases (n = 8) received a booster of 0.2 mmol/kg gadolinium 30-40 minut es later; clinical follow-up was obtained 121/2 to 19 months later. RE SULTS: Drop metastases appeared as nodular areas of enhancement in 11 patients. Vascular enhancement related to the spinal cord surface and emerging nerve roots was observed in images obtained in all control pa tients, as well as in patients with negative findings at lumbar punctu re and at clinical or MR imaging follow-up examination (n = 6). Vascul ar and nerve root enhancement increased with triple-dose gadolinium an d was greater in patients after radiation therapy (n = 17) than in con trol patients (n = 3). CONCLUSION: Use of triple-dose gadolinium did n ot result in detection of additional cases of drop metastases.