摘要
目的 :分析系统性恶性肿瘤脑膜转移的MRI表现 ,探讨脑膜强化对脑膜转移的诊断及鉴别诊断价值。方法 :根据临床恶性肿瘤病史、脑脊液及病理检查确诊的脑膜转移瘤 12例 ,其中原发肿瘤肺癌 5例 ,乳腺癌 3例 ,黑色素瘤1例 ,淋巴瘤 2例 ,原发肿瘤不明 1例。MR常规扫描后均行钆喷替酸葡甲胺 (Gd DTPA)增强扫描。结果 :①MR平扫 :异常脑膜改变仅 2例 ,表现为沿软脑膜分布的多发结节 ;②MR增强扫描 :12例呈 3种脑膜强化模式 ,硬脑膜强化模式 (硬脑膜 蛛网膜强化 ) 3例 ,软脑膜强化模式 (蛛网膜下腔 软脑膜强化 ) 6例 ,全脑膜强化模式 (硬脑膜、蛛网膜及软脑膜均强化 )3例 ,其中 2例表现为沿软脑膜分布的多发结节 ,10例表现为线样弥漫性脑膜强化 ;③其它征象 :脑内转移 3例 ,脑积水 3例。结论 :恶性肿瘤脑膜转移在MR增强扫描上可以表现为 3种脑膜强化模式 ,其中软脑膜强化模式多见 。
Objective:To analyze MR imaging features and enhancing patterns of meningeal metastasis by systemic malignancy,and assess their values for the diagnosis.Methods:There were 12 patients with meningeal metastasis confirmed by clinical data,CFS and pathology.The metastasis was from lung cancer in 5,mammary cancer in 3,melanoma in 1,lymphoma in 1 and unknown malignancy in 1.All patients were examined plain and enhanced MRI.Results:①Plain MRI: multiple nodules along leptomeninges in 2 cases.②Enhanced MRI:12 cases showed 3 kinds of enhancing patterns including dural enhanced pattern in 3 cases,leptomeninx enhanced pattern in 3 and dural leptomeninx enhanced pattern in 3.two of 12 cases revealed multiple nodules along leptomeninges and the remaining 10 showed diffusive linear enhancing meninges.③Other signs: there were cerebral metastasis in 3 and hydrocephalus in 3.Conclusion:Meningeal metastasis by systemic malignancy has 3 types of meninx enhancement on enhanced MRI,where leptomeninx enhanced pattern is usually seen.Moreover,nodules along meninges and cerebral metastasis may be of specificity.
出处
《放射学实践》
2003年第10期706-708,共3页
Radiologic Practice
