单发性脑转移瘤的CT诊断与鉴别诊断(附18例分析)

CT diagnosis and differential diagnosis of solitary brain metastasis (report of 18 cases)

目的提高对单发脑转移瘤(SBM)的CT诊断和鉴别诊断的准确性。方法分析经临床及病理证实的18例SBM的CT平扫及增强表现。结果本组SBM幕上14例,小脑3例,脑干1例。瘤体位于脑皮质及皮质下区占77.8%,且有明显强化。环状强化占27.8%,结节状强化占69.2%。幕上中重度瘤周水肿占77.8%。结论临床病史及原发灶在单发转移瘤的诊断与鉴别诊断中具有重要价值。单发脑转移瘤易于误诊,正确诊断需多方面综合判断。

Objective To improve accuracy of CT diagnosis and differential diagnosis of solitary brain metastasis （SBM） . Methods The CT findings of non-enhanced scan and contrast enhanced scan of the SBM, pathologically confirmed, was retrospectively analyzed in 18cases. Results Supratentorial SBM were found in 14 cases. 3 lesions were revealed in cerebellum while another one was located in the brain stem. There were 77.8% lesions located in the cerebral cortex and subcortical region. Most of the lesions were circular （27.8%） or nodal （69. 2% ） enhanced with the adjacent cerebral oedema. Conclusion Clinical history and primary lesion play an important role in diagnosis and differential diagnosis. The CT manifestations of solitary brain metastasis are often misleading, so accurate diagnosis should be based on comprehensive evaluation.