Objective:The aim was to analyse the clinical features of leptomeningeal metastasis with banded high signal in the brainstem.Methods:In this paper,we report two cases of lung adenocarcinoma with soft meningeal metasta...Objective:The aim was to analyse the clinical features of leptomeningeal metastasis with banded high signal in the brainstem.Methods:In this paper,we report two cases of lung adenocarcinoma with soft meningeal metastasis,collected from the First Affiliated Hospital of Hainan Medical College,and searched the databases of CNKI,Wanfang,VIP,PubMed,Web of Science,and other databases which reported the MRI manifestation of"brainstem bandlike high signal",and collected the patients'past medical history,symptoms,signs,genetic findings,cerebrospinal fluid manifestation,treatment,and prognosis.Result:A total of 28 patients were included,of whom 26 had a history of lung adenocarcinoma and 2 were found to have occupational changes in the lungs.Magnetic resonance imaging(MRI)showed a band-like high signal in the ventral part of the brainstem on T2-FLAIR,symmetrical on both sides,which could extend to the cerebellar peduncles,with high signals on diffusion-weighted imaging(DWI),low signals on apparent diffusion coefficient(ADC),and long T1 signals on T1-weighted imaging,long T2 signals on T2 weighted imaging,and no long T2 signals on enhancement scan.T1-weighted imaging was a long T1 signal,T2-weighted imaging was a long T2 signal,and no enhancement was seen on enhanced scanning.Conclusion:It is important to recognize leptomeningeal metastasis of lung cancer,and the non-enhancing band of high signal in the brainstem on T2-FLAIR and DWI is likely to be the characteristic manifestation of leptomeningeal metastasis of non-small cell lung cancer.展开更多
目的基于静息态功能磁共振成像(rs-fMRI)探讨卒中后早期认知下降患者大脑静息态脑网络功能连接变化。方法连续招募2021年5月至11月于海南医学院第一附属医院神经内科急性轻型缺血性卒中患者66例,所有患者均完成神经心理学评估,根据是否...目的基于静息态功能磁共振成像(rs-fMRI)探讨卒中后早期认知下降患者大脑静息态脑网络功能连接变化。方法连续招募2021年5月至11月于海南医学院第一附属医院神经内科急性轻型缺血性卒中患者66例,所有患者均完成神经心理学评估,根据是否简易智能状态检查量表(MMSE)评分<26分分为认知下降组35例和认知正常组31例。完成rs-fMRI扫描,比较2组前默认网络(aDMN)、后默认网络(pDMN)和执行控制网络(ECN)的功能连接(FC)改变,采用族错误率(FWE)校正。结果认知下降组蒙特利尔认知评估量表评分、MMSE总分、执行、注意力、记忆力、定向力评分明显低于认知正常组,差异有统计学意义(P<0.01)。与认知正常组比较,认知下降组aDMN左侧额中回、背外侧额上回FC明显减弱(P=0.000,FWE校正),pDMN右侧豆状壳核、左侧角回、右侧后扣带回、左侧顶下缘角回、右侧顶下缘角回FC明显减弱(P<0.05,P<0.01,FWE校正),ECN右侧海马旁回和左侧舌回的FC明显增加,在左侧后扣带回、双侧额中回和背外侧额上回的FC明显减弱(P<0.01,FWE校正)。与认知正常组比较,认知下降组pDMN与ECN间的FC明显增强(0.755±0.338 vs 0.110±0.298,P=0.000)。认知下降组ECN左额中回、背外侧额上回的FC与注意力评分呈负相关(r=-0.363,P=0.045)。认知下降组aDMN左额中回、背外侧额上回的FC与执行功能评分呈正相关(r=0.481,P=0.006)。结论卒中后早期认知功能下降患者的默认模式网络和ECN发生变化,左侧额中回、背外侧额上回的FC改变与卒中后早期认知功能下降的发生有关。展开更多
基金Hainan Clinical Medical Center Construction Project(2021)Excellent Talent Team of Hainan Province(No.QRCBT202121)Key R&D Program of Hainan Province(No.ZDYF2022SHFZ109)。
文摘Objective:The aim was to analyse the clinical features of leptomeningeal metastasis with banded high signal in the brainstem.Methods:In this paper,we report two cases of lung adenocarcinoma with soft meningeal metastasis,collected from the First Affiliated Hospital of Hainan Medical College,and searched the databases of CNKI,Wanfang,VIP,PubMed,Web of Science,and other databases which reported the MRI manifestation of"brainstem bandlike high signal",and collected the patients'past medical history,symptoms,signs,genetic findings,cerebrospinal fluid manifestation,treatment,and prognosis.Result:A total of 28 patients were included,of whom 26 had a history of lung adenocarcinoma and 2 were found to have occupational changes in the lungs.Magnetic resonance imaging(MRI)showed a band-like high signal in the ventral part of the brainstem on T2-FLAIR,symmetrical on both sides,which could extend to the cerebellar peduncles,with high signals on diffusion-weighted imaging(DWI),low signals on apparent diffusion coefficient(ADC),and long T1 signals on T1-weighted imaging,long T2 signals on T2 weighted imaging,and no long T2 signals on enhancement scan.T1-weighted imaging was a long T1 signal,T2-weighted imaging was a long T2 signal,and no enhancement was seen on enhanced scanning.Conclusion:It is important to recognize leptomeningeal metastasis of lung cancer,and the non-enhancing band of high signal in the brainstem on T2-FLAIR and DWI is likely to be the characteristic manifestation of leptomeningeal metastasis of non-small cell lung cancer.
文摘目的基于静息态功能磁共振成像(rs-fMRI)探讨卒中后早期认知下降患者大脑静息态脑网络功能连接变化。方法连续招募2021年5月至11月于海南医学院第一附属医院神经内科急性轻型缺血性卒中患者66例,所有患者均完成神经心理学评估,根据是否简易智能状态检查量表(MMSE)评分<26分分为认知下降组35例和认知正常组31例。完成rs-fMRI扫描,比较2组前默认网络(aDMN)、后默认网络(pDMN)和执行控制网络(ECN)的功能连接(FC)改变,采用族错误率(FWE)校正。结果认知下降组蒙特利尔认知评估量表评分、MMSE总分、执行、注意力、记忆力、定向力评分明显低于认知正常组,差异有统计学意义(P<0.01)。与认知正常组比较,认知下降组aDMN左侧额中回、背外侧额上回FC明显减弱(P=0.000,FWE校正),pDMN右侧豆状壳核、左侧角回、右侧后扣带回、左侧顶下缘角回、右侧顶下缘角回FC明显减弱(P<0.05,P<0.01,FWE校正),ECN右侧海马旁回和左侧舌回的FC明显增加,在左侧后扣带回、双侧额中回和背外侧额上回的FC明显减弱(P<0.01,FWE校正)。与认知正常组比较,认知下降组pDMN与ECN间的FC明显增强(0.755±0.338 vs 0.110±0.298,P=0.000)。认知下降组ECN左额中回、背外侧额上回的FC与注意力评分呈负相关(r=-0.363,P=0.045)。认知下降组aDMN左额中回、背外侧额上回的FC与执行功能评分呈正相关(r=0.481,P=0.006)。结论卒中后早期认知功能下降患者的默认模式网络和ECN发生变化,左侧额中回、背外侧额上回的FC改变与卒中后早期认知功能下降的发生有关。
