基于MRI影像学检查研究肺癌脑转移瘤与病理类型的关系

Relationship between Brain Metastases and Pathological Types of Lung Cancer Based on MRI Imaging

目的分析MRI影像学检查研究肺癌脑转移瘤与病理类型的关系。方法取我院2017年1月至2019年1月收治的肺癌脑转移瘤患者70例。所有患者接受MRI检查,使用GE公司生产的3.0T超导型磁共振诊断扫描仪。由2名经验丰富的MRI医师进行双盲独立审片,将审片结果密封后送至研究小组。组内成员根据病理检查结果对MRI结果情况判断阳性情况,分析MRI影像学检查研究肺癌脑转移瘤与病理类型的关系。结果MRI诊断鳞癌、腺癌、小细胞肺癌阳性例数分别为8例(80.00%)、31例(96.88%)、25例(89.29%)。MRI诊断多发转移阳性例数40例(93.02%),多发转移中误诊的有3例(6.98%)。单发转移例数27例,MRI诊断单发转移阳性例数27例(100%)。MRI诊断肺癌脑转移瘤高分化型13例(92.86%)、中分化型33例(94.29%)、低分化型18例(85.71%)。MRI诊断肺癌脑转移瘤水肿阳性情况为无水肿13例(72.22%)、轻度水肿15例(75.00%)、中度水肿18例(85.71%)、重度水肿10例(90.91%)。MRI诊断肺癌脑转移瘤类型、转移、分化、水肿与病理呈正相关(P<0.05)。结论肺癌脑转移瘤类型、转移数量、分化、水肿的MRI图像与病理有一定的相关性,增强扫描容易发现平扫未发现的病灶,有助于临床治疗。

Objective To investigate the relationship between brain metastases and pathological types of lung cancer based on MRI imaging.Methods 70 lung cancer patients with brain metastases admitted to our hospital from January 2017 to January 2019 were selected,and all patients received the MRI,and the images were checked by two experienced physicians.The diagnosis results of MRI were analyzed based on pathological results,then the relationship between brain metastases of lung cancer and pathological types was analyzed.Results The positive cases of squamous cell carcinoma,adenocarcinoma and small cell lung cancer diagnosed by MRI were 8 cases(80.00%),31 cases(96.88%)and 25 cases(89.29%).Squamous cell carcinoma was misdiagnosed as adenocarcinoma in 1 case(10%)and small-cell lung cancer in 1 case(10%).Small cell lung cancer was misdiagnosed as squamous cell carcinoma in 1 case(3.57%)and adenocarcinoma in 2 cases(7.14%).MRI showed that there were 40 cases(93.02%)with multiple metastases and 27 cases(100%)with single metastases.3 cases(6.98%)were misdiagnosed in single metastases.MRI diagnosis showed 13 cases(92.86%)with high differentiation,33 cases(94.29%)with moderate differentiation,and 18 cases(85.71%)with poor differentiation.There were 13 cases without edema(72.22%),15 cases with mild edema(75.00%),18 cases with moderate edema(85.71%)and 10 cases with severe edema(90.91%)diagnosed by MRI.The type,metastasis,differentiation and edema of brain metastases of lung cancer diagnosed by MRI were positively correlated with pathology on MRI(P<0.05).Conclusion The type,metastasis,differentiation and edema of brain metastases are correlated with pathology,enhanced MRI is value to find more lesions than plain scan,which is helpful for clinical treatment.