摘要
目的：探讨肺癌的病理类型与脑转移瘤的数目及合并瘤内出血的关系。方法：回顾性分析经病理证实为肺源性脑转移瘤合并出血的43例患者的临床影像资料，探讨不同病理类型肺癌发生脑转移瘤数目及伴发瘤内出血的关系。结果：43例脑转移瘤均合并出血，MRI均可见血肿的MRI信号特点，其中29例出血信号周围或内部可见肿瘤组织信号，20例范围不甚清晰，9例肿瘤信号范围较大，增强扫描等信号区呈环状或斑片状强化，另外14例增强扫描未见明显强化表现。腺癌脑转移瘤合并出血最多24例、小细胞癌次之14例、鳞癌4例，大细胞神经内分泌癌1例；腺癌脑转移瘤合并出血24例中，多发转移灶20例，单发病灶4例；小细胞癌14例中，多发转移灶3例，单发病灶11例；鳞癌4例中，多发转移灶1例，单发病灶3例；大细胞神经内分泌癌1例单发。经统计学分析，腺癌与小细胞癌合并出血性脑转移的比率明显高于鳞癌与大细胞神经内分泌癌，而腺癌与小细胞癌间无统计学差异。本组中5例误诊。结论：肺源性脑转移瘤合并瘤内出血MRI表现具有一定的特征，增强扫描有助于病变的定性诊断；肺癌脑转移瘤合并出血与病理类型具有一定的相关性，腺癌与小细胞癌合并出血多见，鳞癌与大细胞癌相对少。
Abstract
Objective: To investigate the relationship between the pathological types of lung cancer and the number of intracranial hemorrhagic metastases. Methods: The clinical imaging findings of 43 cases of intracranial hemorrhagic metastases from lung cancer confirmed by pathology were retrospectively analyzed, and the correlation between imaging features of intracranial hemorrhagic metastases from lung cancer and the pathological types of the primary tumor were evaluated. Results: All 43 cases of intracranial hemorrhagic metastases showed hematoma, and 29 cases of them showed hemorrhage within or around tumor, 20 cases of tumor edge were not very clear, 9 cases of tumor signal range is larger, enhanced MRI showed a ring or patchy enhancement. In addition, there was no obvious enhancement in 14 cases. The intracranial hemorrhagic metastases from adenocarcinoma (20 cases of multiple lesions, 4 cases of single lesion), from small cell carcinoma 14 cases(3 cases of multiple lesions, 11 cases of single lesion), from squamous cell carcinoma 4 cases(1 case of multiple lesions, 3 cases of single lesion), and from large cell neuroendocrine carcinoma 1 case (single lesion). Statistically, the ratio of adenocarcinoma and small cell carcinoma with hemorrhagic brain metastasis was significantly higher than that of squamous cell carcinoma and Large cell neuroendocrine carcinoma, and there was no significant difference between adenocarcinoma and small cell carcinoma. 5 cases of all patients were misdiagnosed. Conclusion: The MR imaging findings of intracranial hemorrhagic metastases from lung cancer have certain features, and enhanced MRI is helpful for qualitative diagnosis of brain metastasis. The intracranial hemorrhagic metastases from lung cancer was correlated with pathological types of the primary tumor. Adenocarcinoma and small cell carcinoma complicated with hemorrhage more common, squamous cell carcinoma and large cell carcinoma is relatively less.
关键词
肺肿瘤 /
脑肿瘤 /
肿瘤转移 /
脑出血 /
磁共振成像
Key words
Lung neoplasms /
Brain neoplasms /
Neoplasm metastasis /
Cerebral hemorrhage /
Magnetic resonance imaging
王生海;吴 鹏;陈海海;张振显;李佩玲.
肺癌脑转移合并出血的影像特征及其与病理类型的相关性[J]. 中国临床医学影像杂志. 2015, 26(9): 609-611
WANG Sheng-hai;WU Peng;CHEN Hai-hai;ZHANG Zhen-xian;LI Pei-ling.
Correlation between the imaging features of intracranial hemorrhagic metastases from lung cancer andthe pathological types of the primary tumor[J]. Journal of China Clinic Medical Imaging. 2015, 26(9): 609-611
中图分类号：
Ｒ734.2
R739.41
Ｒ743.34
R445.2
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