脑膜癌病的MRI表现

MR Imaging Features of Meningeal Carcinomatosis

目的 探讨脑膜癌病的MRI表现特点。资料与方法 对 13例确诊为脑膜癌病的患者 ,行头颅MRI常规扫描和Gd DTPA增强扫描 ,分析脑膜癌病患者的MRI表现。结果 MRI常规扫描脑膜均未见异常。增强后 ,按脑膜强化的部位分 :硬脑膜 蛛网膜强化 1例 ,软脑膜 蛛网膜下腔强化 2例 ,混合型强化 8例 ;按脑膜强化的形式分 :线型强化 7例 ,混合型强化 4例 ,无单纯结节型强化。 2例脑膜无任何形式强化的患者 ,其中 1例腰髓增强MRI检查见硬脊膜线型强化。其他影像学表现为脑沟回消失、侧脑室增大、交通性脑积水等。结论 国内脑膜癌病患者的MRI表现与国外不一致 ,国内患者更适合采用脑膜强化的形式分类方法 ,增强MRI检查在显示脑膜异常方面极为敏感 。

Objective To investigate MR imaging features of meningeal carcinomatosis.Materials and Methods Both conventional and gadolinium enhanced MR scanning of the skull were performed in 13 patients with proved meningeal carcinomatosis. MRI features were analyzed.Results No meningeal abnormalities were found on conventional MR scans. After administration of gadolinium, enhancement was seen at dura-arachnoid (n=1), at pia mater-subarachnoid space (n=2), or at both sites (n=8). The enhancement took the form of linear (n=7) or mixed (n=4) pattern. Purely nodular enhancement was not found. No meningeal enhancement in any form was seen in 2 patients, of which linear enhancement of dura mater was seen in one on lumbar enhanced MRI. Other MRI findings included the obliteration of sulci, dilatation of ventricles and communicating hydrocephalus.Conclusion MRI manifestations of meningeal carcinomatosis seen in Chinese are different from those seen in foreigners abroad. The classification based on the meningeal enhancement patterns is more suitable for Chinese patients and is very sensitive in detecting meningeal abnormalities. It is of great help for the diagnosis of meningeal carcinomatosis.