实用医学影像杂志
實用醫學影像雜誌
실용의학영상잡지
JOURNAL OF PRACTICAL MEDICAL IMAGING
2014年
4期
258-260
,共3页
林春%张楚和%吕怀志%唐振国%李亮平
林春%張楚和%呂懷誌%唐振國%李亮平
림춘%장초화%려부지%당진국%리량평
脑肿瘤%诊断%误诊%体层摄影术,X线计算机
腦腫瘤%診斷%誤診%體層攝影術,X線計算機
뇌종류%진단%오진%체층섭영술,X선계산궤
Brain neoplasms%Diagnosis%Diagnostic errors%Tomography,X-ray computed
目的:探讨颅内单发转移瘤的CT表现及诊断价值。方法回顾性分析42例经手术病理证实或临床综合诊断确诊的颅内单发转移瘤CT表现。结果病灶位于皮质及皮质下区34例,小脑5例,松果体区2例,桥脑1例。 CT平扫表现为:囊实性23例,实性12例,囊性7例;增强扫描表现为4种类型:囊实形强化17例,不规则环形强化12例,结节形强化9例,均匀强化4例;38例瘤周水肿较明显。误诊为胶质瘤13例,脑膜瘤4例,生殖细胞瘤例2例,脑脓肿2例。结论颅内单发转移瘤多位于大脑灰白质交界区,CT表现多样,可表现为结节、环形及囊实性不规则形,多伴有明显水肿,水肿与周围组织分界较清晰,当缺乏原发病史时,易与颅内其他单发病变混淆,年龄、发生部位、边界、增强形态等有助于鉴别诊断。
目的:探討顱內單髮轉移瘤的CT錶現及診斷價值。方法迴顧性分析42例經手術病理證實或臨床綜閤診斷確診的顱內單髮轉移瘤CT錶現。結果病竈位于皮質及皮質下區34例,小腦5例,鬆果體區2例,橋腦1例。 CT平掃錶現為:囊實性23例,實性12例,囊性7例;增彊掃描錶現為4種類型:囊實形彊化17例,不規則環形彊化12例,結節形彊化9例,均勻彊化4例;38例瘤週水腫較明顯。誤診為膠質瘤13例,腦膜瘤4例,生殖細胞瘤例2例,腦膿腫2例。結論顱內單髮轉移瘤多位于大腦灰白質交界區,CT錶現多樣,可錶現為結節、環形及囊實性不規則形,多伴有明顯水腫,水腫與週圍組織分界較清晰,噹缺乏原髮病史時,易與顱內其他單髮病變混淆,年齡、髮生部位、邊界、增彊形態等有助于鑒彆診斷。
목적:탐토로내단발전이류적CT표현급진단개치。방법회고성분석42례경수술병리증실혹림상종합진단학진적로내단발전이류CT표현。결과병조위우피질급피질하구34례,소뇌5례,송과체구2례,교뇌1례。 CT평소표현위:낭실성23례,실성12례,낭성7례;증강소묘표현위4충류형:낭실형강화17례,불규칙배형강화12례,결절형강화9례,균균강화4례;38례류주수종교명현。오진위효질류13례,뇌막류4례,생식세포류례2례,뇌농종2례。결론로내단발전이류다위우대뇌회백질교계구,CT표현다양,가표현위결절、배형급낭실성불규칙형,다반유명현수종,수종여주위조직분계교청석,당결핍원발병사시,역여로내기타단발병변혼효,년령、발생부위、변계、증강형태등유조우감별진단。
Objective To explore CT manifestations of intracranial solitary metastasis and diagnosis value. Methods Retrospectively analyze the CT features of 42 cases of intracranial solitary metastasis proved by clinical general inspection and diagnosis or pathology. Results The lesions of 34 cases were at cortical and subcortical areas with cerebellum in 5 cases,pineal region in 2 cases, pons in 1 case. By plain scan, there were 23 cases of cystic-solid brain metastases, 12 cases of solid brain metastases and 7 cases of cystic brain metastases. The enhancement type could be divided into 4 types:nodular-cystic,irregular,nodular and regular, which were 17, 12, 9, 4 cases respectively. The oedema around the tumours in 38 cases was obvious. 13 cases were misdiagnosed as glioma ,4 cases as menin-giomas,2 cases as germinoma, 2 cases as abscess. Conclusion Intracranial solitary metastasis located at junctional zone between ectocinerea and alba of cerebrum. Shapes of metastatic tumor are multiple, such as node, ring-shaped and cyst-solid node were commonly seen. Most of these were accompanied with marked hydropsia. Intracranial solitary metastasis with unknown primary tumors are easy to be misdiagnosed while the patients′age,the location,edge and en-hanced features of the tumors can contribute to the differentiation diagnosis.