脑膜癌25例临床分析

A clinical analysis of 25 cases of meningeal carcinomatosis

目的探讨脑膜癌的临床、影像学及脑脊液特点。方法回顾性分析25例脑膜癌患者的临床、影像学及实验室检查资料。结果 25例患者中,男14例,女11例。头痛19例,恶心呕吐15例,复视7例,视力下降6例,听力下降5例,癫痫8例,智能减退6例,小便障碍6例。所有患者均行腰椎穿刺检查,脑脊液白细胞升高21例,蛋白升高17例,葡萄糖降低17例。25例患者均行MRI检查,脑膜强化征15例,脊膜强化征6例,脊髓内病变7例。结论脑膜癌是恶性肿瘤颅内转移的特殊形式,脑脊液细胞学检查是诊断金标准,影像学显示脑膜结节样或混合型强化是明确诊断的重要依据。

Objective To investigate the clinical, imaging and cerebrospinal fluid （CSF） characteristics of meningeal carcinomatosis, and improve the level of diagnosis and treatment. Methods The clinical, imaging and laboratory data of 25 patients with meningeal carcinomatosis were analyzed retrospectively. Results Fourteen male and 11 female patients were included. Among the 25 patients, headache occurred in 19 cases, nausea and vomiting in 15 cases, diplopia in 7 cases, vision loss in 6 cases, hearing loss in 5 cases, epilepsy in 8 cases, mental impairment in 6 cases, and urination disorder in 6 cases. All the patients underwent lumbar puncture, WBC in CSF increased in 21 cases, protein elevated in 17 cases, glucose decreased in 17 cases. All patients underwent MRI, the imaging showed meningeal enhancement in 15 cases, spinal enhancement in 6 cases, spinal cord lesions in 7 cases. Conclusion Meningeal carcinomatosis is a special form of intracranial metastasis of malignant tumor, and CSF cytology is still the gold standard for diagnosis. Imaging shows meningeal nodular or mixed type of intensive diagnosis are important means of diagnosis.