摘要
目的:总结肺癌脑转移病灶的常规MRI表现,并对其中部分病例行DWI和(或)MRS检查,以提高对肺癌脑转移的认识。材料和方法:回顾性分析经我院检查确诊的肺癌脑转移病例共177例,接受常规MRI序列检查。手术病理或临床病史证实的32例肺癌脑转移瘤病例,临床处理前接受DWI和(或)2D1H-MRS检查。分析其弥散及波谱表现特征,分别测定肿瘤实质、坏死/囊变部分、瘤周水肿部分及正常脑实质ADC值,以及Cho/Cr、NAA/Cr、NAA/Cho等代谢比率。结果:病灶强化方式以环状和结节状为主。环形强化的特征为外壁光滑,内壁毛糙,壁厚薄不均匀,强化不均。肿瘤实质部分ADC值为1.08±0.37×10mm2/s,囊变部分ADC值为2.5±0.36×10mm2/s。与瘤周水肿区及正常脑实质ADC值有显著差异性。肿瘤实质部分Cho峰多降低,CR峰降低,NAA峰多测不到。肿瘤组织与瘤周水肿区及正常脑实质的代谢比率(Cho/Cr)有显著差异性,而瘤周水肿区与正常脑实质的代谢比率无明显差异。结论:肺癌脑转移MRI强化主要表现为环形强化和结节状强化,环形强化有一定的特征表现可与其他病变鉴别。其在弥散及波谱图像上有一定的特点,与常规MRI序列结合可明显提高诊断准确性。
Purpose： To promote diagnosis of brain metastasis from lung cancer through Conventional MRI , DWI and MRS. Materials and Methods： 177 cases of brain metastasis from lung cancer were analyzed retrospec- tively. All these cases got conventional MRI sequences.Among there, 32 cases received DWI and/ or MRS. The ADC value , the ratio of Cho/Cr,NAA/Cr and NAA/Cho were measure respectory in tumor, peritumoral region and normal brain. Results： Ring - like and nodular enhancement dominate among 177 cases, the features of ring- like enhancement were smooth outer wail, coarse inner wail, uneven of the wall thickness, and heterogenous enhancement. The ADC value of the parenchymatous parts of the tumor were 1.08 ＋ 0.37 mm^2/ s, and the necrotic parts were 2.5 ＋ 0.36 mm^2/ s. Significant deviation of ADC value can be found among tumor, peritumoral region and normal brain. The peak of Cho in the parenchy- matous parts of the tumor were decrese mostly, and the peak of NAA were absent in most cases. The different of Cho/Cr among tumor, peritumoral region and normal brain were found significant deviation. Conclusion： The main post - contrasted MRI appearance of brain metastasis from lung cancer were ring - like and nodular enhancement, and there are characteristic features of ring - like enhancement differ from other lesions. Some features can be found in brain metastases with diffusion - weighted and magnetic resonance spectroscopy. Combination of them is helpful in diagnosis and differential diagnosis .
出处
《中国医学计算机成像杂志》
CSCD
2005年第4期227-231,共5页
Chinese Computed Medical Imaging
