Leptomeningeal Neoplasm and Mimics: A Pictorial Review

Leptomeningeal enhancement is seen in a variety of primary and metastatic neoplasms. Other conditions, including inflammatory disease, infection, and infarction, can also present with leptomeningeal enhancement. MR imaging has a critical role in the identification of leptomeningeal disease; however, the differential diagnosis of leptomeningeal enhancement is broad, and clues to the diagnosis involve evaluation of the pattern and distribution of enhancement, associated imaging findings, the patient's clinical presentation, and, ultimately, CSF analysis. The purpose of this pictorial review was to familiarize the radiologist with imaging manifestations of leptomeningeal disease across a broad range of neoplastic and non-neoplastic processes.

Learning Objective: To review the imaging manifestations of leptomeningeal disease in a broad range of neoplastic and non-neoplastic mimicking entities.