摘要
目的探讨颅内外肿瘤脑脊膜转移途径及MRI特征。方法收集我院经手术、活检病理或脑脊液细胞学检查确诊的脑脊膜转移瘤126例,对其转移途径、MRI平扫及增强特征进行回顾性分析。结果直接侵犯多见于原发颅外肿瘤,尤其是鼻咽癌,MRI多表现为连续线状脑脊膜或室管膜增厚,鼻咽癌转移灶可呈大片状明显增厚,最厚可达1cm以上;脑脊液播散多见于原发颅内肿瘤,MRI表现为线状、结节状脑脊膜或室管膜增厚;血行播散多见于原发颅外肿瘤,MRI表现为线状、结节状异常强化,以结节状强化多见;混合型多见于原发颅外肿瘤,MRI表现为线状、结节状、片状异常强化,其中3例呈硬脑膜、软脑膜、室管膜广泛异常强化;MRI平扫部分病灶无法发现,而增强扫描能发现更多病灶。结论颅内外肿瘤脑脊膜转移途径不尽相同,不同转移途径影像表现也各异,MRI增强扫描能对其准确评估。
Objective To investigate the meningeal metastasis route and MRI features of intracranial and extracranial neoplasms.Methods 126 cases of meningeal metastasis proved by operation, pathology or CSF cytology were included into the study, and retrospectively analyze the route of metastasis and MRI appearances, Results Direct violation was prevalent in extracranial tumors, especially in nasopharyngeal cancer, the incrassate meninges and ependyma were being seen.The flaky thickening was being seen in nasopharyngeal carcinoma, and the maximum thickness was more than lcm. CSF dissemination was prevalent in intracranial neoplasms, showed setuliform or nodular pattern. Hematogenous metastasis was prevalent in extracranial neoplasnls,showed the setuliform or nodular pattern in enhanced MRI,especially in nodular one. Mixed type was prevalent in extracranial neoplasms,showed setuliform, flaky or nodular pattern,and the widely abnormal enhancement in cerebral dura mater, cerebral pia mater and ependyma were being seen in 3 cases. Part of the lesions can not be found on MR scan , and can be found after enhanced. Conclusion The route of meningeal metastasis were different between intracranial and extracranial neoplasms, there were different imaging findings in different route of metastasis, and the accurately assessment can be perfomled on enhanced MR imaging.
出处
《中国CT和MRI杂志》
2014年第1期42-45,共4页
Chinese Journal of CT and MRI
基金
广东省江门市科技攻关课题(编号:2006-35)
关键词
脑脊膜
肿瘤
转移途径
磁共振成像
Meninges
Neoplasms
Route of metastasis
Magnetic resonance imaging
