肺癌单发脑转移瘤的磁共振表现

目的:探讨肺癌单发脑转移瘤(SBM)的MRI表现,提高对单发脑转移瘤的诊断准确性.方法:回顾性分析经手术病理和临床证实的39例肺癌单发脑转移瘤的MRI表现,分析单发瘤体发生的部位、大小、形态、瘤体出血、瘤周水肿程度和瘤体的强化特点.结果:39个SBM,发生于幕上32例,其中31例瘤体位于皮质和皮质下区,7例位于幕下.增强扫描示病灶呈结节状强化18例,环状强化5例,囊实性强化16例.肺腺癌转移瘤内出血4例(4/5),肺鳞癌脑转移瘤出现囊变或囊实性强化11例(11/21).中重度水肿大多出现在≥2cm的实性或囊实性强化的瘤体(22/39)中.结论:肺癌单发脑转移瘤的MRI表现具有一定的特征性,MRI增强扫描对诊断单发脑转移瘤有重要价值.

MRI Manifestations of Solitary Brain Metastases of Lung Cancer

Objective:To study the MRI characteristics of solitary brain metastasis (SBM) of lung cancer, and to improve the diagnostic accuracy of SBM.Methods:MRI findings of 39 patients with SBM of lung cancer proven by pathology and clinical follow-up were studied retrospectively.The location,size,shape,intra-tumoral hemorrhage,peri-tumoral edema as well as findings after contrast enhancement were analyzed.Results:Of the 39 cases of SBM having pre-contrast MRI,32 lesions were located at the supra-tentorial regions,with 31 lesions at the cerebral cortex and subcortical regions.7 lesions located at the infratentorial regions.After contrast-enhancement,various patterns were revealed,including nodular enhancement (18 lesions),ring-like enhancement (5 lesions),enhanced solid-cystic mass (16 lesions).In all of these metastases,4 of the 5 cases with SBM of pulmonary adenocarcinoma showed intra-tumoral hemorrhage foci.11 of the 21 cases with SBM of pulmonary squamous carcinoma had cystic change or solid-cystic enhancement.22 of the 39 SEM which were larger than 2cm with solid or cystic-solid enhancement showed moderate to marked peri-tumoral edema.Conclusion:SBM of lung cancer had some characteristic features in contrast enhanced MR images,which showed important value in the diagnosis and differential diagnosis of SBM of lung cancer.