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Journal of Neurology

, Volume 246, Issue 9, pp 810–814 | Cite as

The diagnostic accuracy of magnetic resonance imaging and cerebrospinal fluid cytology in leptomeningeal metastasis

  • Chiara S. M. Straathof
  • Hein G. de Bruin
  • Diederik W. J. Dippel
  • Ch. J. Vecht
Original communication

Abstract

Diagnostic decision making in the case of patients suspected of having leptomeningeal metastasis (LM) can be very difficult. The results of cerebrospinal fluid (CSF) cytology can be repeatedly negative, and the predictive value of gadolinium-enhanced magnetic resonance imaging (MRI) is not well known. We report the results of CSF cytology and Gd MRI in 61 patients with known cancer, suspected of having LM. We combined our data with those from a similar study and calculated the sensitivity and specificity of CSF and Gd MRI, in the absence of a “gold standard diagnosis.” CSF cytology was positive for LM in 35 patients and MRI in 38. With CSF cytology sensitivity 75% and specificity 100%, with Gd MRI sensitivity was 76% but specificity only 77%. We conclude that Gd MRI provides strong support in the diagnosis of LM in patients with cancer who have negative results on CSF cytology.

Key words Leptomeningeal metastasis Magnetic resonance imaging Cerebrospinal fluid cytology Sensitivity Specificity 

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Copyright information

© Steinkopff Verlag 1999

Authors and Affiliations

  • Chiara S. M. Straathof
    • 1
  • Hein G. de Bruin
    • 2
  • Diederik W. J. Dippel
    • 3
  • Ch. J. Vecht
    • 1
  1. 1.Department of Neuro-oncology, University Hospital Rotterdam and Dr. Daniel den Hoed Cancer Center, PO Box 5021 3008 AE Rotterdam, The Netherlands e-mail: vecht@neuh.azr.nl, Tel.: +31-10-4391415, Fax: +31-10-4391031NL
  2. 2.Department of Radiology, University Hospital Rotterdam and Dr. Daniel den Hoed Cancer Center, PO Box 5021 3008 AE Rotterdam, The NetherlandsNL
  3. 3.Department of Neurology, University Hospital Rotterdam and Dr. Daniel den Hoed Cancer Center, PO Box 5021 3008 AE Rotterdam, The NetherlandsNL

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