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1、脑转移瘤在低场MRI诊断及鉴别诊断［摘要］目的探讨脑转移瘤在低场MR的表现，以提高诊断及鉴别诊断水平。方法回顾性分析经手术病理或临床证实的47例脑转移瘤的MR平扫及增强扫描图像表现。结果脑转移瘤幕上37例，幕下6例，幕上、幕下同时发生4例；多发脑转移瘤41例、单发脑转移瘤6例；瘤周无水肿3例、轻度水肿8例、中度水肿11例、重度水肿25例；增强扫描共发现158个瘤灶,T1WI低信号112个、等信号32个、混杂信号14个,T2WI高信号115个、混杂信号39个、等信号4个;T1WI强化，斑片强化23个、环形强化61个
2、、结节强化63个、不规则强化11个。结论MRI平扫及增强扫描对脑转移瘤的诊断及鉴别诊断具有重要价值。［关键词］磁共振成像;脑转移瘤；诊断及鉴别诊断［中图分类号1R445.2［文献标识码］A［文章编号］1005-0515(2010)-8-225-01DiagnosisandDifferentialDiagnosisoflow-fieldMRIinBrainMetastasisZhouWei-qiangLinFa-hon(DepartmentofCTandMRI,thethirdHospitalofZigongCit
3、y)[Abstract]ObjectiveTostudytheMRIcharacteristicsofbrainmetastasis,andtoimprovethediagnosticaccuracyofbrainmetastasis.MethodsTocollect47casesofbrainmetastasesdiagnosedbyclinicalandsurgicalpathology,andtoretrospectivelyanalysetheirMRIcharacteristics..Results37
4、caseswereSupratentorialmetastasis,6caseswereinfratentorialmetastasis,4caseswereSupratentorialandinfratentorialmetastasis；41casesweremultiplebrainmetastasis,6caseswereSinglebrainmetastases；3caseswerewithouthydropsia,3caseswerewithmildhydropsia,11caseswerewithm
5、oderatehydropsia,25caseswerewithstronghydropsia；Enhancementscanningfound158focus,T1WI：lowsignalwere112,equisignalwere32,mixsignalwere14；T2WI:highsignalwere115,mixsignalwere39,equisignalwere4；T1WIintensification：patchintensifiedtionwere23,ring-shapedintensific
6、ationwere61,nodusintensificationwere63,irregularintensificationwere11.ConclusionMRIscanningandenhancementscanningarevaluableinthediagnosisanddifferentialdiagnosisofbrainmetastasis・[Keywords]MRI；Brainmetastasis；diagnosisanddifferentialdiagnosis恶性肿瘤发生颅内转移颇为常见，其
7、中以脑转移最多。今年来随着低场MRI在基层医院的广泛应用，小的转移灶可被早期发现，有效的提高了脑转移瘤的检出率及诊断率。本文对本院2006-2009年间47例经手术病理或临床证实的脑转移瘤进行回顾性分析，探讨脑转移瘤在低场MRI的表现，以提高脑转移瘤的诊断及鉴别诊断水平。1资料与方法1.1一般资料47例中，男30例,女17例，年龄34-71岁，平均年龄53.4岁；临床以头昏、头痛等颅内高压症状首发者34例，有视力障碍、语言及运动功能障碍13例；其中肺癌转移29例，乳腺癌10例，甲状腺癌4例，鼻咽癌2例，未找到原发
8、癌2例。1.2检查方法采用安科公司OPENMARK0.2TMRI扫描仪,头线圈，自旋回波序列，常规进行横断位、冠状位T2WI、T1WI扫描，扫描条件T2WITR/TE4000/130ms；TlWI350/16ms；强化扫描做横断位、冠状位T1WI层面与平扫同层面对照，造影剂选用Gd-DTPA,剂量为0.2mmol/kg,行手背静脉推注。2结果2.1瘤灶部位及形态特点幕上3
