肺癌脑转移患者MRI表现与原发灶病理类型的关系  

Relationship between MRI findings and brain metastases in patients with lung cancer

作　　者：郑穗敏[1] 翁志蓬[1] 欧建宏[1] ZHENG Sui-min;WENG Zhi-peng;OU Jian-hong(Medical Imaging Center,Shunde Hospital,Guangzhou University of Traditional Chinese Medicine,Shunde 528000,Guangdong,CHINA)

机构地区：[1]广州中医药大学顺德医院医学影像中心,广东顺德528000

出　　处：《海南医学》2022年第7期910-914,共5页Hainan Medical Journal

摘　　要：目的研究肺癌脑转移患者的MRI表现与原发灶病理类型的关系。方法选择2013年1月至2020年9月广州中医药大学顺德医院收治的43例肺癌脑转移患者作为研究对象,按病理类型的不同分为腺癌19例、鳞癌10例和小细胞肺癌14例。所有肺癌脑转移患者均行常规MR平扫、DWI扫描和增强扫描检查,比较三种不同病理类型患者的脑转移瘤的数目、大小、强化特点及表观扩散系数(ADC值)、相对扩散系数(rADC值)。结果腺癌、鳞癌和小细胞肺癌患者的脑转移瘤强化特点比较差异无统计学意义(P>0.05);鳞癌患者中单发病灶者占80.00%,明显高于腺癌、小细胞肺癌的31.58%、35.71%,差异有统计学意义(P<0.05);腺癌和小细胞肺癌患者的脑转移瘤数目比较差异无统计学意义(P>0.05);鳞癌患者中脑转移瘤Ⅰ级、Ⅱ级、Ⅲ级的比例分别为36.84%、31.58%、31.58%,与腺癌患者(分别为61.54%、28.57%、9.89%)和小细胞肺癌患者(70.11%、20.69%、9.20%)分别比较差异均有统计学意义(P<0.05);小细胞肺癌患者的ADC值、rADC值明显低于腺癌和鳞癌,差异均有统计学意义(P<0.05),而腺癌和鳞癌患者的ADC值、rADC值比较差异均无统计学意义(P>0.05)。结论肺癌脑转移瘤患者的数目、大小、ADC值与原发灶病理类型有关;鳞癌患者的脑转移瘤多为单发病灶,病灶体积较大,腺癌、小细胞肺癌多见多发病灶,病灶体积相对较小;小细胞肺癌患者的脑转移瘤在DWI图像中显示受限的比例多于腺癌、鳞癌。Objective To study the relationship between MRI findings and brain metastases in patients with lung cancer.Methods Forty-three patients with brain metastases from lung cancer admitted to Guangzhou University of Traditional Chinese Medicine from January 2013 to September 2020 were selected as the research objects.According to the pathological types,they were divided into 19 cases of adenocarcinoma,10 cases of squamous cell carcinoma,and14 cases of small cell lung cancer.All patients underwent conventional MRI,DWI scan,and enhanced scan.The number,size,enhancement characteristics,apparent diffusion coefficient(ADC value),relative apparent diffusion coefficient(rADC value)were observed and compared among different pathological types.Results There were no significant differences in enhancement characteristics among adenocarcinoma,squamous cell carcinoma,and small cell carcinoma(P>0.05).The proportion of single lesion in squamous cell carcinoma was 80.00%,which was significantly higher than31.58% in adenocarcinoma and 35.71%in small cell carcinoma(P<0.05).There was no significant difference in the number of brain metastases between adenocarcinoma and small cell carcinoma(P>0.05).The proportion of brain metastases of grade Ⅰ,Ⅱ,and Ⅲ in patients with squamous cell carcinoma were 36.84%,31.58%,and 31.58%,respectively,which were significantly different from 61.54%,28.57%,and 9.89% in patients with adenocarcinoma and 70.11%,20.69% and 9.20% in patients with small cell carcinoma(P<0.05).ADC value and rADC value of patients with small cell carcinoma were significantly higher than those of adenocarcinoma and squamous cell carcinoma(P<0.05),while the two values showed no statistically significant difference between the patients with adenocarcinoma and those with squamous cell carcinoma(P>0.05).Conclusion The number,size,and ADC value of lung cancer patients with brain metastases are correlated with the pathological types of primary lesions.Most of the brain metastases in patients with squamous cell carcinoma are single l

关 键 词：磁共振成像 小细胞肺癌 脑转移瘤 原发灶病理类型 鳞癌 腺癌 

分 类 号：R734.2[医药卫生—肿瘤]