Abstract
Results of Computerized Axial Tomography with or without intravenous contrast (60% Conroy) in 47 patients with metastatic brain tumor were analyzed. Twelve patients had lesions of the lung and eleven carcinoma of the breast. Ten other primary sites are represented in this series. These data were compared to isotope brain scan (Tc99) done in 31 and angiography in 17 of these same patients. A total of 67 tumors were demonstrated. Thirty-eight patients had single metastasis.
Without the use of contrast, 47/66 tumors were identified on computerized axial tomography. An additional 19 tumors were positively demonstrated by use of intravenous contrast. In the 35 patients given the contrast agent, 34/49 lesions revealed enhancement. Peri-tumor edema was demonstrable in 61 lesions.
In the cases available for comparison (17) there was little demonstrable correlation between hypervascularity as seen on angiography and contrast medium enhancement.
Five of thirty eight tumors found on computerized axial tomography were not identified by Tc99 scan. The area of increased uptake on Tc99 scan was larger than measurments of the tumor in 29/33 lesions but smaller than the area of peri-tumor edema in all but 2 instances.
This study reveals that in neoplasms metastatic to brain, computerized axial tomography is superior to Tc99 scan in regard to diagnosis, determination of tumor size and extent of edema.
