颅内单发转移瘤MRI表现及19例误诊分析

The MRI Misdiagnosis of Intracranial Solitary Metastasis(19 Cases Report)

目的探讨颅内单发转移瘤MRI表现,分析其误诊原因。方法回顾性分析19例经手术病理证实、无原发病史的颅内单发转移瘤的MRI表现。结果发生于大脑半球皮质及皮质下区10例,小脑、鞍区各2例,胼胝体、侧脑室、松果体区、桥脑及顶骨各1例。术前误诊为胶质瘤9例,脑膜瘤3例,垂体瘤、室管膜瘤各2例,脑脓肿、淋巴瘤、生殖细胞瘤各1例。结论颅内单发转移瘤MRI表现多样,尤其当缺乏原发病史时,易与颅内其他单发病变混淆,其中年龄、发生部位、边界、增强形态等有助于鉴别诊断。

Objective To explore MRI manifestations of intracranial solitary metastasis and analyze the reasons of mis- diagnosis. Methods MR findings of 19 cases with intracranial solitary metastasis proved by surgery and pathology were analyzed retrospectively, any signs of primary tumors were not found in all cases before MRI examination. Results The tumors located at cortical and subcortical areas in 10 cases, cerebellum and the sellar region in 2 cases respectively, 1 case in corpus eallosum, lateral ventricle, pineal region, pons and parietal bone respectively. 9 cases were misdiagnosed as glio- ma, 3 cases as meningiomas, 2 cases as pituitary adenoma and ependymoma respectively, 1 case as abscess, lymphoma and germinoma respectively. Conclusion Intracranial solitary metastasis, especially with unknown primary tumors, are easy to misdiagnosed as other intracranial solitary lesions, the patient＇s age, the location, edge and enhanced features of the tumors can contribute to the differentiation diagnosis.