脑膜癌病的临床与影像学表现(附8例分析与文献复习)

目的 探讨脑膜癌病的临床特点及影像学表现。并结合文献讨论其早期诊断与治疗。方法 对8例经临床。头颅CT/MRI，脑脊液（CSF）细胞学检查确诊的脑膜癌病患者资料进行综合分析。结果 既有脑症状，又有脑膜刺激征者6例；颅神经损害以后组颅神经，视神经及听神经为主要表现者分别为4例，2例及2例；多组颅神经同时损害4例。脊神经损害2例。CSF细胞学检查均发现癌细胞。早期头颅CT/MRI增强扫描可见脑膜线状与条状异常增强，可有交通性脑积水，脑实质也可有异常强化。6例于3个月内先后死亡。结论 脑膜癌病主要表现为头痛，多组颅神经和（或）脊神经损害及脑膜刺激征。CT/MRI对脑膜癌病的早期诊断有重要意义。且MRI优于CT，CSF发现癌细胞仍是确诊脑膜癌病最简便与最直接的证据。

The clinical manifestations and imaging findings of meningeal carcinomatosis( an analysis of 8 cases and literature review)

Objective To investigate the clinical manifestations and imaging findings of meningeal carcinomatosis(MC), and to discuss the diagnosis and treatment of MC combined with literature review. Methods 8 cases of MC, confirmed by clinical, manifestations, cranial CT/MRI, the cytologic study of cerebrospinal fluid(CSF) were analyzed fully. Results Of them, 6 cases had brain symptoms and meningeal irritation. After cranial nerves were damaged, 4 cases, 2 cases and 2 cases were mainly characterized by the manifestations of cranial nerves, optic nerve and acoustic nerve, respectively. In addition, 4 cases showed multiple cranial nerves damage at the same time and 2 showed spinal nerves damage. The cytologic study of CSF showed tumor cells in all patients. The early CT/MRI enhanced scanning found abnormal linear and strip enhancement of meninge and communicating hydrocephalus as well as abnormal enhancement of cerebral matter. 6 patients died within 3 months. Conclusion MC is characteized by headache, multiple cranial and spinal nerves damage and meningeal irritation. CT/MRI examination is important to the early diagnosis of MC, in which MRI is superior to CT. The most convenient and direct evidence in diagnosing MC is still cytologic study of CSF.