肺癌脑转移合并出血的影像特征及其与病理类型的相关性

发布时间：2019-05-21 21:56

【摘要】：目的:探讨肺癌的病理类型与脑转移瘤的数目及合并瘤内出血的关系。方法 :回顾性分析经病理证实为肺源性脑转移瘤合并出血的43例患者的临床影像资料,探讨不同病理类型肺癌发生脑转移瘤数目及伴发瘤内出血的关系。结果:43例脑转移瘤均合并出血,MRI均可见血肿的MRI信号特点,其中29例出血信号周围或内部可见肿瘤组织信号,20例范围不甚清晰,9例肿瘤信号范围较大,增强扫描等信号区呈环状或斑片状强化,另外14例增强扫描未见明显强化表现。腺癌脑转移瘤合并出血最多24例、小细胞癌次之14例、鳞癌4例,大细胞神经内分泌癌1例;腺癌脑转移瘤合并出血24例中,多发转移灶20例,单发病灶4例;小细胞癌14例中,多发转移灶3例,单发病灶11例;鳞癌4例中,多发转移灶1例,单发病灶3例;大细胞神经内分泌癌1例单发。经统计学分析,腺癌与小细胞癌合并出血性脑转移的比率明显高于鳞癌与大细胞神经内分泌癌,而腺癌与小细胞癌间无统计学差异。本组中5例误诊。结论:肺源性脑转移瘤合并瘤内出血MRI表现具有一定的特征,增强扫描有助于病变的定性诊断;肺癌脑转移瘤合并出血与病理类型具有一定的相关性,腺癌与小细胞癌合并出血多见,鳞癌与大细胞癌相对少。
[Abstract]:Objective: to investigate the relationship between the pathological types of lung cancer and the number of brain metastases and intratumor hemorrhage. Methods: the clinical imaging data of 43 patients with pulmonary brain metastases complicated with hemorrhage confirmed by pathology were analyzed retrospectively. the relationship between the number of brain metastases and intratumoral hemorrhage in different pathological types of lung cancer was discussed. Results: all 43 cases of brain metastases were complicated with hemorrhage. The MRI signal characteristics of hematomas could be seen on MRI. The signal intensity of tumor tissue was seen in 29 cases, the range of tumor tissue was not very clear in 20 cases, and the signal range of 9 cases was large. The signal area such as enhanced scan showed annular or patchy enhancement, while the other 14 cases showed no obvious enhancement. There were 24 cases of brain metastases complicated with hemorrhage, 14 cases of small cell carcinoma, 4 cases of small cell carcinoma, 1 case of large cell neuroendocrine carcinoma, 20 cases of multiple metastases and 4 cases of single lesions in 24 cases of brain metastases complicated with hemorrhage. There were 3 cases of multiple metastases and 11 cases of single lesions in 14 cases of small cell carcinoma, 1 case of multiple metastases and 3 cases of single lesions in 4 cases of small cell carcinoma, and 1 case of large cell neuroendocrine carcinoma. Statistical analysis showed that the rate of hemorrhagic brain metastasis in adenocarcinoma and small cell carcinoma was significantly higher than that in squamous cell carcinoma and large cell neuroendocrine carcinoma, but there was no significant difference between adenocarcinoma and small cell carcinoma. In this group, 5 cases were misdiagnosed. Conclusion: MRI findings of pulmonary brain metastases complicated with intratumor hemorrhage have certain characteristics. Enhanced scan is helpful to the qualitative diagnosis of pulmonary brain metastases. There is a certain correlation between brain metastases complicated with hemorrhage and pathological types in lung cancer. Adenocarcinoma and small cell carcinoma complicated with hemorrhage are more common, while squamous cell carcinoma and large cell carcinoma are relatively few.
【作者单位】：中国医科大学附属第一医院放射科;延安市人民医院CT诊断科;
【分类号】：R734.2;R445.2

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