脑干带状高信号的软脑膜转移临床特征分析  

Analysis of clinical characteristics of leptomeningeal metastasis with band⁃like high signal in the brainstem

作　　者：林慧霞 刘婷 杨逸昊 栗菲 梁斌基 李丽娟 李治群[1,2] 李其富 LIN Huixia;LIU Ting;YANG Yihao;LI Fei;LIANG Binji;LI Lijuan;LI Zhiqun;LI Qifu(Department of Neurology,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Key Laboratory of Tropical Brain Science Research and Translation in Hainan Province Hainan,Haikou 570102,China)

机构地区：[1]海南医学院第一附属医院神经内科,海南海口570102 [2]海南省热带脑科学研究与转化重点实验室,海南海口570102

出　　处：《海南医学院学报》2024年第4期273-278,共6页Journal of Hainan Medical University

基　　金：海南省临床医学中心建设项目(2021);海南省优秀人才团队(QRCBT202121);海南省重点研发计划(ZDYF2022SHFZ109)。

摘　　要：目的:分析脑干带状高信号的软脑膜转移病例的临床特征。方法:收集海南医学院第一附属医院及检索知网、万方、维普、PubMed、Web of Science等数据库中报道磁共振表现为脑干带状高信号的患者,收集并整理纳入患者的既往病史、症状、体征、基因检查结果、脑脊液表现、治疗及预后等。结果:共纳入28例患者,其中26例有肺腺癌病史,2例发现肺部占位性改变,磁共振均表现为T2‐FLAIR上脑干腹侧呈带状高信号,两侧对称,可延伸至小脑脚,DWI呈高信号,ADC呈低信号,T1加权成像为长T1信号,T2加权成像为长T2信号,增强扫描未见强化。结论:识别肺癌继发软脑膜转移很重要,T2‐FLAIR和DWI上脑干无强化带状高信号很可能是非小细胞肺癌继发软脑膜转移的特征性表现。Objective:To analysis the clinical features of leptomeningeal metastasis with banded high signal in the brainstem.Methods:This study has collected data of patients with band‐like high signal in brainstem manifested by MRI from the first Affiliated Hospital of Hainan Medical University,searched the databases of CNKI,Wanfang,VIP,PubMed,Web of Science,and other databases which reported the MRI manifestation of"brainstem band‐like high signal",and collected the patients'past medical history,symptoms,signs,genetic findings,cerebrospinal fluid manifestation,treatment,and prognosis.Results:A total of 28 patients were included,of whom 26 had a history of lung adenocarcinoma and two were found to have occupational changes in the lungs.MRI showed a band‐like high signal in the ventral part of the brainstem on T2‐FLAIR,symmetrical on both sides,which could extend to the cerebellar peduncles,with high signals on diffusion‐weighted imaging(DWI),low signals on apparent diffusion coefficient(ADC),and long T1 signals on T1‐weighted imaging,long T2 signals on T2 weighted imaging,and no long T2 signals on enhancement scan.T1‐weighted imaging was a long T1 signal,T2‐weighted imaging was a long T2 signal,and no enhancement was seen on enhanced scanning.Conclusion:It is important to recognize leptomeningeal metastasis of lung cancer,and the non‐enhancing band of high signal in the brainstem on T2‐FLAIR and DWI is likely to be the characteristic manifestation of leptomeningeal metastasis of non‐small cell lung cancer.

关 键 词：软脑膜转移 带状高信号 肺腺癌 磁共振成像 脑脊液 血脑屏障 

分 类 号：R739.45[医药卫生—肿瘤]