The ability visually to diagnose meningeal abnormalities of the brain and spinal cord has improved markedly with the advent of gadoliniium-enhanced agnetic resonance (MR) imaging. Meningeal abnormalities can be appreciated in 90% of these cases, but only after the use of intravenous contrast medium. Abnomral enhancement of the meninges is related to increased vasucliarty or vascular permeability as a reaction to a disease process. Differential considerations fall into those of infection, neoplastic (either primary or secondary), granulomatous/inflammatory, or vascular. Direct relationship to the patient's history and clinical course should be correlated with the MR examination.
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