Gadolinium-enhanced MR imaging in pediatric chiasmatic gilomas

The use of gadolinium appears to improve the diagnostic accuracy of MR imaging in adult patients with intracranial malignancy. Reports of pediatric brain tumors diagnosed with gadolinium-enhanced MR imaging (Gd-MR) are mostly anecdotal. The authors have reviewed Gd-MR findings in seven patients (aged 2--12 years) with chiasmatic gliomas to determine if the use of gadolinium improved the accuracy of MR imaging in this clinical setting. MR imaging was performed with a 0.35-T magnet. Sequences included axial, sagittal, T1-weighted (TR 500/TE 30), and T2-weighted (TR 2,500/TE 40,80) images. Following intravenous gadolinium administration, T1-weighted images were acquired. No patients were being treated with steroids. All patients underwent surgical biopsy. Gadolinium-enhanced T1-weighted images were compared with T2-weighted images with respect to visibility of residual tumor and local metastases. Chiasmatic gliomas in two patients demonstrated no enhancement. Three tumors showed intense enhancement