脑脊膜转移的MRI表现

目的：总结脑脊膜转移的ＭＲＩ表现及其与原发肿瘤的关系。材料与方法：复习２０例符合下述３项标准的病例的临床及ＭＲＩ资料：（１）有病理证实的原发恶性肿瘤史；（２）新近发生神经系统症状和体征；（３）静脉注射ＧｄＤＴＰＡ后ＭＲＩ示脑脊膜异常强化。结果：原发肿瘤：癌１２例，非何杰金淋巴瘤８例。ＭＲＩ表现有：（１）脑脊膜异常强化２０例；（２）神经根异常强化１３例，其中马尾终丝病变１０例；（３）脑积水２例。脑脊膜异常强化分４型：硬膜蛛网膜型３例；软膜蛛网膜型１０例；室管膜型５例；混合型２例。病灶分布形式：局限型６例，均为淋巴瘤；弥漫型９例，均为癌。结论：脑脊膜转移的ＭＲＩ直接征象为脑脊膜异常强化。局限型多见于淋巴瘤，播散型多见于癌。

神经系统转移瘤的诊治

神经系统转移瘤包括:颅内转移、脊髓转移,软脑脊膜转移和外周神经转移。

宫颈癌患者脊髓髓内和软脑膜转移1例

Background.: Neoplastic meningitis in patients with carcinoma of the uterine cervix is unusual in the course of their diseases. Even more unusual are intramedullary spinal metastases. Case.: We report the case of a 64-year-old woman who presented with leptomeningeal and intramedullary spinal cord metastases from a grade 2 squamous cell cancer of the uterine cervix. This is just the second case of intramedullary metastases from cervical carcinoma. Conclusion.: Neoplastic meningitis or intramedullary metastases are extremely rare in the course of uterine cervix carcinoma. Nevertheless, when indicated by symptoms, patients should undergo MRI of the brain and/or spine and have a lumbar puncture performed, for the diagnosis of this devastating complication. Treatment is mainly palliative but may offer symptom relief.

松果体瘤的治疗

松果体瘤约占颅内肿瘤的0.4%～2%。多见于幼儿及青少年。好发于松果体区,第三脑室前部及鞍上区,偶见于额叶及基底节。松果体瘤以往组织学分类和命名较为混乱,近年来已比较明确,可分为4类: (1)生殖细胞源性肿瘤,包括生殖细胞瘤,畸胎瘤,胚胎细胞癌等; (2)松果体细胞源性肿瘤,包括松果体细胞瘤和松果体母细胞瘤; (3)其它细胞源肿瘤,包括胶质瘤等。松果体生殖细胞瘤最为常见,占50%以上。 松果体瘤最常见的转移方式为经脑脊液沿整个脑室系统播散,通常种植于脑脊膜及脊髓,由于重力的原因,骶尾部较脊髓其它部位更易种植。李顺业等报道松果体瘤脑脊膜转移率高达57%。至于脊髓种植率。