肺癌脑室内转移瘤对伴发脑膜转移的提示意义  

Clinical significance of intraventricular metastasis in patients with concomitant leptomeningeal metastasis from lung cancer

作　　者：潘振宇[1] 袁婷婷[2] 杨国姿[1] 王爱林[3] 石硙岩[1] 董丽华[1] 

机构地区：[1]吉林大学第一医院放疗科,长春130021 [2]吉林大学第一医院影像科,长春130021 [3]吉林大学第一医院检验科,长春130021

出　　处：《中华神经医学杂志》2013年第12期1279-1282,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨肺癌患者磁共振（MRa-）检查显示脑室内转移瘤是否对可能同时存在的脑膜转移具有提示作用。方法选取吉林大学第一医院放疗科自2010年12月至2013年1月收治的19例头部MIu检查证实存在脑室内转移病灶，并具有脑脊液相关检查的肺癌患者，分析其临床及影像学表现、脑脊液检查结果等相关临床资料。结果19例患者均合并脑实质内转移病灶；16例患者脑室内病灶位于侧脑室，4例位于第三脑室，8例位于第四脑室及中脑导水管；其中9例同时存在脑室内2个部位转移病灶，呈播散性特点。结合病史、影像学表现、临床特点及脑脊液检查，13例患者占（68％）诊断为脑膜转移。结论存在脑室内转移的肺癌患者，具有较高的伴发脑膜转移几率，具有提示作用；脑室内转移是肺癌脑膜转移的特征性影像学表现之一。根据脑膜转移发生途径，参考影像学表现，脑室内转移瘤可以导致脑膜转移发生：脑膜转移的继发性种植亦可形成脑室内转移瘤。Objective To investigate the significance of intraventricular metastasis in the diagnosis of leptomeningeal metastasis from lung cancer. Methods Nineteen lung cancer patients with intraventricular metastasis, admitted to and confirmed by brain MRI in our hospital from May 2010 to December 2012, were selected in our study. All of the patients accepted cerebrospinal fluid （CSF） examination. The clinical and imaging findings and CSF examination results were analyzed. Results All 19 patients had cerebral parenchyma metastasis; the lesions of 16 patients located in the lateral ventricle, 4 in the third ventricle and 8 in the fourth ventricle and aquaeductus cerebra; 9 patients had 2 metastatic lesions ofintraventricular, which were disseminated. According to the disease history, imaging manifestation, clinical features and CSF examination results, 13 patients （68%） were diagnosed with leptomeningeal metastasis. Conclusions Referring to the mechanism of leptomeningeal metastasis and imaging findings, intraventricular metastasis can lead to leptomeningeal metastasis; while tumor cells implantation caused by leptomeningeal metastasis can also form intraventricular metastasis. Therefore, intraventricular metastasis has the suggestive role for the diagnosis of leptomeningeal metastasis from lung cancer; intraventficular metastasis is one of the imaging characteristics in leptomeningeal metastasis from lung cancer.

关 键 词：肺癌 脑膜转移 脑室内转移 影像学 诊断 

分 类 号：R734.2[医药卫生—肿瘤]