颅内单发转移瘤的CT诊断及误诊分析  

CT diagnosis and misdiagnosis of intracranial solitary metastasis

作　　者：林春[1] 张楚和 吕怀志 唐振国[1] 李亮平[2] 

机构地区：[1]广东省揭西县棉湖华侨医院CT室,515438 [2]嘉应学院医学院附属医院影像科

出　　处：《实用医学影像杂志》2014年第4期258-260,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨颅内单发转移瘤的CT表现及诊断价值。方法回顾性分析42例经手术病理证实或临床综合诊断确诊的颅内单发转移瘤CT表现。结果病灶位于皮质及皮质下区34例,小脑5例,松果体区2例,桥脑1例。CT平扫表现为:囊实性23例,实性12例,囊性7例;增强扫描表现为4种类型:囊实形强化17例,不规则环形强化12例,结节形强化9例,均匀强化4例;38例瘤周水肿较明显。误诊为胶质瘤13例,脑膜瘤4例,生殖细胞瘤例2例,脑脓肿2例。结论颅内单发转移瘤多位于大脑灰白质交界区,CT表现多样,可表现为结节、环形及囊实性不规则形,多伴有明显水肿,水肿与周围组织分界较清晰,当缺乏原发病史时,易与颅内其他单发病变混淆,年龄、发生部位、边界、增强形态等有助于鉴别诊断。Objective To explore CT manifestations of intracranial solitary metastasis and diagnosis value. Methods Retrospectively analyze the CT features of 42 cases of intracranial solitary metastasis proved by clinical general inspection and diagnosis or pathology. Results The lesions of 34 cases were at cortical and subcortical areas with cerebellum in 5 cases,pineal region in 2 cases, pons in 1 case. By plain scan, there were 23 cases of cystic-solid brain metastases, 12 cases of solid brain metastases and 7 cases of cystic brain metastases. The enhancement type could be divided into 4 types：nodular-cystic,irregular,nodular and regular, which were 17, 12, 9, 4 cases respectively. The oedema around the tumours in 38 cases was obvious. 13 cases were misdiagnosed as glioma ,4 cases as menin-giomas,2 cases as germinoma, 2 cases as abscess. Conclusion Intracranial solitary metastasis located at junctional zone between ectocinerea and alba of cerebrum. Shapes of metastatic tumor are multiple, such as node, ring-shaped and cyst-solid node were commonly seen. Most of these were accompanied with marked hydropsia. Intracranial solitary metastasis with unknown primary tumors are easy to be misdiagnosed while the patients′age,the location,edge and en-hanced features of the tumors can contribute to the differentiation diagnosis.

关 键 词：脑肿瘤 诊断 误诊 体层摄影术 X线计算机 

分 类 号：R739.41[医药卫生—肿瘤]