肺癌患者化疗前后脑脊液容量的变化及其临床意义  

Changes of cerebrospinal fluid capacity in patients with lung cancer with or without chemotherapy and its clinical significance

作　　者：赵秋月 梁雪[1] 荣萍 陈文倩 马一鸣[1] 韩小伟 ZHAO Qiuyue;LIANG Xue;RONG Ping;CHEN Wenqian;MA Yiming;HAN Xiaowei(Department of Medical Imaging,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,南京210008

出　　处：《磁共振成像》2023年第9期33-38,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:82171908)。

摘　　要：目的结合横向和纵向分析方法探讨肺癌(lung cancer,LC)及癌症化疗对患者颅内脑脊液(cerebrospinal fluid,CSF)总量以及各亚区CSF容量的影响。材料与方法横向研究中,回顾性分析2019年5月至2021年12月期间于我院就诊的151例LC患者病例,其中38例接受化疗。同时招募39例健康对照(healthy control,HC)。利用单因素方差分析方法比较三组CSF总量以及各亚区CSF容量的差异,将显著差异的指标与各组LC患者癌症相关临床资料进行相关性分析。纵向研究中,回顾性分析2020年7月至2022年1月期间收治本院的另外20例LC患者病例,使用配对t检验方法比较其前后两次CSF容量的改变,将显著差异指标与随访时间间隔进行相关性分析。结果横向研究中,未化疗和化疗LC患者组的第三脑室和右侧侧脑室CSF容量均显著高于HC组(P<0.05),并且在化疗组中,肿瘤大小与第三脑室CSF容量呈正相关关系(P<0.05)。纵向研究显示,与第一次颅脑扫描时相比,LC患者在第二次随访后颅内CSF总量、外周CSF以及左侧侧脑室CSF容量均显著增加(P<0.05),并且相应CSF差值与两次随访时间间隔呈正相关关系(P<0.05)。结论LC及化疗导致患者多个脑室CSF容量发生异常改变,因此CSF容量变化可能为LC诊断提供新的神经影像学标记,并且协助指导癌症化疗。Objective:To explore the effects of lung cancer(LC)and chemotherapy on the total amount of intracranial cerebrospinal fluid(CSF)and the volume of CSF in various subregions in patients with LC by using both horizontal and vertical analysis methods.Materials and Methods:In the horizontal study,151 cases of patient with LC admitted to our hospital from May 2019 to December 2021 were retrospectively analyzed,of which 38 receivied chemotherapy.Meanwhile,39 healthy controls(HC)were recruited.The differences of total CSF volume and CSF capacity in each subregion were compared among the three groups by one-way ANOVA.Then the correlations between the significantly different indicators and cancer-related clinical data in each group were carried out.In the longitudinal study,an additional 20 cases of LC patients admitted to our hospital between July 2020 and January 2022 were then retrospectively analyzed.The paired t-test method was used to compare the changes in CSF volume between the two times,and then,the correlation analyses were performed between the significantly different indexes and the follow-up interval.Results:In the transverse study,the CSF volume in the third ventricle and right lateral ventricle of LC patients with chemotherapy and without chemotherapy were significantly higher than that of the HC group(P<0.05).And in the chemotherapy group,the tumor size was positively correlated with the CSF in the third ventricle(P<0.05).The longitudinal study showed that compared with the first brain scan,the volume of intracranial,peripheral and left lateral ventricle CSF in LC patients increased significantly after the second follow-up(P<0.05).And the CSF differences above were positively associated with the follow-up interval(P<0.05).Conclusions:LC and chemotherapy lead to aberrant CSF volume in multiple ventricles,which may provide a new neuroimaging marker for LC diagnosis and assist in guiding cancer chemotherapy.

关 键 词：肺癌 化疗相关脑损伤 脑脊液 三维T1加权成像 磁共振成像 横断面研究 纵向研究 

分 类 号：R445.2[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]