不同类型肺癌脑转移瘤病灶MSCT图像特征对比

Comparison on MSCT Image Features of Different Types of Brain Metastases from Lung Cancer

目的分析不同类型肺癌脑转移瘤病灶MSCT图像特征。方法收集本院2018年1月至2019年4月收治的67例肺癌脑转移瘤患者影临床资料,其中34例腺癌,21例鳞癌,8例腺鳞癌,2例大细胞癌,2例小细胞癌。分析患者MSCT图像,观察不同病理类型肺癌脑转移瘤病灶在患者脑内分布、数目、位置、强化特点、周围水肿、病灶与周围临近组织关系等情况。结果腺癌共检出转移病灶78处,鳞癌33处,腺鳞癌脑转移灶13处,小细胞癌4处,大细胞癌2处;不同类型肺癌脑转移瘤病灶部位均为顶叶居多,水肿程度相似均以重度水肿多见;转移病灶均出现不同程度强化,而鳞癌以环形强化为主,腺癌、小细胞癌以结节性强化为主,极少数病灶不强化。结论不同类型肺癌脑转移瘤病灶数目、强化形式CT影像表现存在差异,通过分析影像学表现可为临床鉴别诊断提供参考依据。

Objective To analyze the MSCT image features of different types of brain metastases from lung cancer.Methods The clinical data of 67 patients with brain metastases from lung cancer treated in our hospital from January 2018 to April 2019 were collected,including 34 cases with adenocarcinoma,21cases with squamous cell carcinoma,8 cases with adenosquamous carcinoma,2 cases with large cell carcinoma,and 2 cases with small cell carcinoma.The MSCT images of the patients were analyzed to observe the distribution,number,location,enhancement characteristics,peripheral edema,and relationship between the lesions and surrounding tissues in patients with different types of brain metastases from lung cancer.Results 78 metastatic lesions were detected in patients with adenocarcinoma,33 metastatic lesions were detected in patients with asquamous cell carcinoma,13 metastatic lesions were detected in patients with adenosquamous carcinoma,4 metastatic lesions were detected in patients with small cell carcinoma,and 2 metastatic lesions were detected in patients with large cell carcinoma.The lesions of different types of brain metastases from lung cancer are mostly parietal lobe,and the degree of edema is similar.Severe edema is more common.Metastatic lesions all showed different degrees of enhancement,while squamous cell carcinoma was dominated by ring enhancement,adenocarcinoma and small cell carcinoma were mainly nodular enhancement,and few lesions were not enhanced.Conclusion There are differences in the number of lesions,enhanced forms,and CT imaging manifestations in different types of brain metastases from lung cancer.The analysis on imaging characteristics can provide reference for clinical differential diagnosis.