脑膜癌病的磁共振成像征象分析  

MR imaging features of meningeal carcinomatosis

作　　者：米芳[1] 李小波[1] 张红鸭[1] 刘鸽[2] 田晓甲 贾宏阁[1] 

机构地区：[1]第四军医大学西京医院神经内科,陕西西安710032 [2]第四军医大学西京医院放射科,陕西西安710032

出　　处：《中华神经外科疾病研究杂志》2016年第1期17-20,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(81171181)

摘　　要：目的探讨脑膜癌病的MRI表现,提高对脑膜癌病的影像学认识和诊断水平。方法对67例确诊的脑膜癌病患者的MRI平扫及增强影像学资料进行回顾性分析,总结其影像学特点。结果MRI平扫脑膜均未见异常信号,间接征象包括脑转移瘤11例,脑室扩大、脑积水8例;33例行增强检查后,18例(54.5%)有不同程度的脑膜强化。按脑膜强化的部位,10例显示软脑膜型异常强化,5例表现为硬脑膜型强化,3例为全脑膜型强化。按脑膜强化形状,线形强化9例,结节型5例,混合型4例。脑膜强化组与非脑膜强化组脑脊液比较,强化组的脑脊液蛋白和白细胞计数显著高于非强化组,而糖含量明显低于非强化组(P<0.05)。结论增强MRI在显示本组脑膜癌病患者软脑膜-蛛网膜强化方面较为敏感,脑膜结节型或混合型强化是其较具特征的MRI表现,对脑膜癌病有重要的临床诊断价值。Objective To investigate the MR imaging features of meningeal carcinomatosis, and to improve the ability in understanding and diagnosing meningeal carcinomatosis in MR findings. Methods The MRI data of 67 patients with meningeal carcinomatosis confirmed were analyzed retrospectively. Results Conventional imaging showed no evident meningeal abnormalites. The indirect signs included intracranial metastatic tumor （ n = 11 ）, ventriculomegaly and hydrocephalus （n =8）. After enhancement scanning of 33 patients, 18 cases （54.5%） showed different degrees of meningeal reinforcement. The abnormal meningeal enhancement was seen at pia-suharachnoid space in 10 cases, at abnormal dura-arachnoid in 5 cases and all sides in 3 cases. The enhancement took the form of linear pattern in 9 cases, nodular pattern in 5 cases and mixed pattern in 4 cases. The group of meningeal enhancement had a significantly higher cerebrospinal fluid protein and white blood cell count compared with the group of meningeal unenhancement, and the sugar content was lower than that of the group of unenhancement （P 〈0.05）. Conclusion Enhanced MRI is very sensitive to detect pia-subarachnoid space. It can well demonstrate the morphological and pathological evidence of abnormal enhanced meninges. The abnormal meningeal nodular pattern or mixed pattern is the characteristic imaging for the diagnosis of MC, which has an important clinical diagnostic value for meningeal carcinomatosis.

关 键 词：脑膜癌病 磁共振成像 脑膜强化 脑脊液细胞学 

分 类 号：R739.45[医药卫生—肿瘤]