原发灶不明确的颅脑单发转移瘤影像学表现及临床、病理特点  

Imaging findings,clinical and pathological features of solitary brain metastasis with unclear primary tumors

作　　者：韦文桦 伍金凤 陈灵凤 陈炯[3] WEI Wenhua;WU Jinfeng;CHEN Lingfeng;CHEN Jiong(Department of Radiology,the Second Affiliated Hospital of Guilin Medical University,Guilin 541199,China;Department of Pathology,the Second Affiliated Hospital of Guilin Medical University,Guilin 541199,China;Department of Radiology,the Second People's Hospital of Nanning,Nanning 530031,China)

机构地区：[1]桂林医学院第二附属医院放射科,广西桂林541199 [2]桂林医学院第二附属医院病理科,广西桂林541199 [3]南宁市第二人民医院放射科,广西南宁530031

出　　处：《实用放射学杂志》2020年第9期1367-1370,共4页Journal of Practical Radiology

摘　　要：目的探讨体部原发灶不明确的脑内单发转移瘤的影像学表现及临床、病理特点.方法回顾性分析7例颅脑单发转移瘤的影像学表现及术前、术后诊断结果,分析其临床、病理资料.结果7例脑内单发转移瘤中,转移性低分化鼻咽癌、硬膜外转移性甲状腺癌、转移性肉瘤样癌、转移性绒毛膜癌各1例,转移性肺低分化癌1例,转移性肺腺癌2例,体部检查均未发现原发灶.影像学表现为出血1例、肿块5例、囊变1例,强化模式表现为肿块明显强化5例、环形强化1例,脑水肿3例,影像学诊断符合率为28.6%(2/7).结论体部肿瘤不明确的颅脑单发转移瘤病灶孤立、发生部位不固定,表现形式多样,缺乏特征性,确诊比较困难,可能是由于颅脑转移病变提前于原发灶,或者原发灶隐匿性强、检查不一定被发现,或者组织异位及癌细胞复杂的生物学行为所致.Objective To investigate the imaging findings,clinical and pathological features of solitary brain metastases with unclear primary tumors.Methods The imaging findings and preoperative and postoperative diagnosis results of 7 cases with solitary brain metastases were analyzed retrospectively.The clinical and pathological data were analyzed.Results 7 cases of solitary brain metastases included 1 case from nasopharyngeal carcinoma,1 from thyroid carcinoma,1 from sarcomatoid carcinoma,1 from choriocarcinoma,1 from lung hypodifferentiation carcinoma and 2 cases from lung adenocarcinoma.No primary lesions were found.The imaging findings included 1 case of hemorrhage,5 cases of mass and 1 case of cystic change.The enhanced mode showed 5 cases with obvious mass enhancement,1 case with ring enhancement,3 cases with cerebral edema,and the correct imaging diagnosis rate was 28.6%(2/7).Conclusion The manifestations of solitary brain metastasis with unclear primary tumors are variety and lack of characteristics.It is difficult to make the diagnosis.It may be due to the brain lesions being existed before the primary tumor,or complex biological behavior of cancer cells.

关 键 词：脑 转移瘤 计算机体层成像 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R814.42[医药卫生—临床医学]