非小细胞肺癌软脑膜转移的临床特征及磁共振影像分析

Clinical Features and Magnetic Resonance Imaging Analysis of Leptomeningeal Metastases in Non-small Cell Lung Cancer

目的探讨非小细胞肺癌软脑膜转移的临床特征及磁共振影像表现。方法对2022年1月至2023年4月在我院住院诊治的76例非小细胞肺癌伴软脑膜转移患者的临床及MRI资料进行回顾性分析,探讨其临床特征与MRI影像表现。结果非小细胞肺癌软脑膜转移患者临床症状以脑部症状为主,表现为头痛、头晕伴恶心呕吐,还有颅神经、脊髓及脊神经受累症状。脑脊液异常主要包括颅内压升高、蛋白含量升高,葡萄糖、氯化物水平的降低及脑脊液中肿瘤标志物的异常升高。MRI增强多表现为累及多个脑叶软脑膜的弥漫性强化,MRI增强阳性组较阴性组发生脑积水及合并脑转移的几率更大。结论非小细胞肺癌伴软脑膜转移的临床特征及MRI影像表现具一定的特征性,全面认识其临床特点及影像特征性对于患者的早期诊断及治疗预后有一定的价值。

Objective To investigate the clinical features and magnetic resonance imaging findings of leptomeningeal metastasis in non-small cell lung cancer.MethodsClinical and MRI data of 76 patients with non-small cell lung cancer with leptomeningeal metastasis admitted to our hospital from January 2022 to April 2023 were retrospectively analyzed,and their clinical features and MRI imaging findings were discussed.ResultsThe clinical symptoms of patients with leptomeningeal metastasis of NSCLC are mainly cerebral symptoms,including headache,dizziness,nausea and vomiting,and cranial,spinal and spinal nerve involvement.Cerebrospinal fluid abnormalities mainly include elevated intracranial pressure,elevated protein content,decreased glucose and chloride levels,and abnormal elevated tumor markers in cerebrospinal fluid.MRI enhancement mostly showed diffuse enhancement involving multiple lobes of the pia meninges,and the positive MRI enhancement group had a higher probability of hydrocephalus and brain metastasis than the negative MRI enhancement group.ConclusionThe clinical features and MRI images of non-small cell lung cancer with leptomeningeal metastasis have certain characteristics,and a comprehensive understanding of its clinical features and imaging characteristics is of certain value for the early diagnosis and treatment of patients.