脑干转移瘤的MRI诊断与鉴别诊断  

MRI Diagnosis and Differential Diagnosis of Brainstem Metastases

作　　者：刘金来 周清安 金艳 徐焱 贺静 LIU Jin-lai;ZHOU Qing-an;JIN Yan;XU Yan;HE Jing(Department of Radiology,the First Affiliated Hospital of Henan Polytechnic University(JiaozuoNo.2 People's Hospital),Jiaozuo 454001,Henan Province,China)

机构地区：[1]河南理工大学第一附属医院(焦作市第二人民医院)放射科,河南焦作454001

出　　处：《中国CT和MRI杂志》2021年第8期31-33,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨脑干转移瘤的MRI表现及其诊断价值。方法回顾性分析总结75例脑干转移瘤患者的MRI表现,其原发灶均经纤维支气管镜/胃镜、穿刺活检、手术病理证实。结果75例患者中,单独累及脑干者2例(2.7%),合并大脑及小脑转移者59例(79%),仅合并大脑转移者13例(17%),仅合并小脑转移者1例(1.3%)。增强扫描后,仅表现为脑干局部脑膜转移而无实性转移者7例,表现为脑干实性转移者68例。转移灶为单发者49例(72%),多发者19例(28%),其中2例患者表现为脑干弥漫性粟粒结节灶,不能明确计数,余66例患者总共发现88个病灶,强化病灶呈实性结节或球形50个,环状27个,线团状7个,片状4处;其中位于中脑26个(30%)、中脑桥脑交界处1个(1%)、桥脑35个(40%)、桥脑延髓交界处10个(11%)、延髓11个(12%)、累及全脑干者5个(6%)。病变周围伴轻度水肿30个(34%);中度水肿8个(9.1%);重度水肿10个(11.4%);无水肿40个(45.5%)。病灶长径小于等于5mm者59个(67%),大于5mm者29个(33%)。结论脑干转移瘤的MRI表现具有一定特征性,MRI对脑干转移瘤的诊断及鉴别诊断具有重要价值。Objective To investigate the MRI findings and diagnostic value of brainstem metastases.Methods Retrospective analysis of 75 patients with brain stem metastasis MRI findings,the primary lesions were confirmed by fiber optic bronchoscopy/gastroscopy,needle biopsy,surgical pathology.Results Of the 75 patients,2 cases(2.7%)had brainstem alone,59 cases(79%)had brain and cerebellar metastases,and 13 cases(17%)had only brain metastases,and 1 cases(1.3%)had only cerebellar metastases.Post contrast enhanced scan,only 7 cases of brainstem metastases without solid metastases were present,68 cases showed solid brain metastases,49 cases(72%)with single lesions,and 19 cases with multiple lesions(28%).Two of the patients showed diffuse miliary nodules of the brainstem,which could not be counted explicitly.A total of 88 lesions were found in 66 patients.The lesions showed solid nodules or masses of 50,27 rings,7 clusters,and 4 flaky.There are 26(30%)lesions located at the midbrain,the junction of midbrain and pons 1(1%),the pons 35(40%),the junction of the pons and medulla 10(11%),the medulla 11(12%)and 5(6%)involving the whole brain.There were 30(34%)mild edema around the lesion;8(9.1%)with moderate edema;10(11.4%)with severe edema;and 40(45.5%)with no edema.59(67%)of lesions with a diameter of less than or equal to 5 mm and 29(33%)with a diameter greater than 5mm.Conclusion MRI findings of brainstem metastases have certain characteristics.MRI has great value in the diagnosis and differential diagnosis of brainstem metastases.

关 键 词：脑干转移瘤 磁共振成像 诊断 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]