脑转移瘤出血的CT和MRI诊断

目的：探讨脑转移瘤出血的CT、MRI表现特点。方法：经临床或病理证实的脑转移瘤出血51例，男41例，女10例，平均53.6岁，51例全部行CT平扫，其中17例同时行MR平扫，20例行增强CT，14例行增强MR扫描。结果：51例共130个脑转移瘤出血病灶，根据转移瘤内出血灶的形态分为结节肿块型（28例87个病灶）。环型（10例22个病灶）和灶样出血型（16例21个病灶），同一病例可同时存在不同形态的脑转移瘤出血病灶，出血灶在CT平扫时呈高密度，MRT1WI呈高信号，增强扫描各型脑转移瘤出血病灶呈不同程度和形态的强化。结论：脑转移瘤出血形态多样。结节肿块型脑转移瘤出血需要与单纯性脑出血鉴别，环型需要与脑脓肿鉴别，而灶样出血型主要应与各种脑原发恶必肿瘤相鉴别。

CT and MRI diagnosis of hemorrhagic intracranial metastases

Objective:To study the CT and MRI features of hemorrhagic intracranial metastases.Methods:51 cases of hemorrhagic intracranial metastases proved by clinical data and pathology were analyzed.There were 41 males and 10 females with an average age of 53.6 years.All the cases were performed CT scanning,17 with additional MR imaging,20 with additional enhanced CT and 14 with additional enhanced MRI.Results:According to the shape of hemorrhage,130 hemorrhagic intracranial metastases in 51 cases were classified into three types:nodular (n=87 lesions in 28 cases),ringlike (n=22 lesions in 10 cases),and focal hemorrhage type(n=21 lesions in 16 cases).Different types of hemorrhagic metastases could appear in one patient.The hemorrhagic focus showed high density on CT and hyperintensity on MR T 1WI.The tumors of different types were enhanced in varying degrees and shapes on enhanced CT and MRI.Conclusion: Hemorrhagic intracranial metastases show various shapes and should be differentiated as followings:the nodular type from simple brain hemorrhage, the ring type from brain abscess,the focal hemorrhage type from primary malignant brain tumors.