脑转移瘤106例临床分析

Clinical analysis of 106 cases of brain metastatic carcinoma

目的分析脑转移瘤的临床和CT特征及与其他颅内占位性病变的鉴别要点,进一步提高诊断水平,减少误诊。方法我院1990年至2005年经临床、CT及其他检查诊断为脑转移瘤106例,回顾总结其临床表现与解剖生理之间的关系、CT扫描的特点。结果脑转移瘤的临床表现以下述三种类型为主,其中卒中型占46例(43·4%),癫痫型占26例(24·5%),脑瘤型占24例(22·6%),各型临床表现与病灶的解剖生理相关,CT平扫多为低密度或等密度占位,增强扫描病灶均有不同程度强化,灶周水肿明显为其特征。结论脑转移瘤临床表现多种多样,早期容易误诊,原发肿瘤的存在是较重要的诊断依据,增强CT扫描是重要的检查方法。

Objective To investigate the clinical and CT characteristics of metastatic brain carcinoma and the differential diagnosis with other intracranial lesions and promote diagnostic level one step more, and to diminish misdiagnosis. Methods 106 cases metastatic brain tumor confirmed by CT and other methods in our hospital from 1990 to 2005 were retrospectively studied about clinical appearance and the relationship with anatomy and physiology, characteristics of CT and the main point of differential diagnosis. Results Metastatic brain carcinoma mainly could be devided to three following types based on clinical expressions, among them, apoplexic type dominated 46 cases （ 43.4 % ）, epileptic type 26 cases（ 24.5 % ）, brain tumor type 24 cases（21.6 % ）, the clinical expressions correlated to anatomy and phyiology of lesion in each type, CT plain scan most appeared low density or equal density space occupying enhanced CT scan foci showed different degree stronger in lesion,and characteristic of perifocal edema. Conclusion The clinical appearance of brain metastatic carcinoma is various,easily misdiagnosed in early stage,looking for the primary tumor is the rather important diagnostic dependencies, enhanced CT scan is an important diagnostic method.