PMC6884546_01
PMC6884546_02
MRI of the brain and spine with and without contrast at diagnosis. a, b T1-weighted axial images show enhancement of the bilateral fifth cranial nerves after the administration of gadolinium contrast. c, d There is enhancement of the bilateral seventh-eighth cranial nerve complexes. e Sagittal T1-weighted post-contrast spine images demonstrate patchy circumferential enhancement along the thoracic and lumbar spinal cord (arrow heads) and enhancement of the cauda equina nerve roots (arrows), related to leptomeningeal carcinomatosis.
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Fig1
PMC6884546_03
MRI brain and spine, 12 months following treatment with olaparib. a, b Axial T1-weighted post-contrast images show resolved enhancement of the fifth cranial nerves (a, arrowhead) and seventh-eighth cranial nerves complexes (b, arrows). Linear enhancement adjacent to the right seventh-eighth cranial nerve complex was consistent with a vascular loop. c Sagittal T1-weight MRI of the spine, post contrast, shows minimal enhancement anterior to the thoracic spinal cord (arrowhead) and subtle enhancement within the cauda equina nerve roots (arrow).
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Fig2
One year from LC diagnosis and initiation of olaparib, brain MRI showed complete resolution of previous cranial nerve enhancement (Fig. 2a, b). Spinal MRI at that time showed resolution of circumferential thoracic and lumbar spine enhancement, with only vague enhancement and no thickening of the cauda equina nerve roots (Fig. 2c).