242.Diffuse leptomeningeal metastasis 弥漫性软脑膜转移瘤

2020

07/07

腹部医学影像论坛

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今日份英语阅读文章已送达！

Homogeneous thin enhancement limited to the dura is commonly seen in patients post-craniotomy and should not be confused with dural tumor metastases, which are usually thick and nodular. In patients in whom spine MR is performed subsequent to contrast-enhanced cranial MR, a "boost" half-dose of contrast may be helpful since significant time may elapse during the process of changing from head to spine coils with certain scanners. Addition of fat saturation pulses to the T1-weighted sequences may aid in detection of leptomeningeal disease in the spine. In patients without a known primary neoplasm, it is important to remember that infectious, granulomatous, and unusual disorders such as idiopathic pachymeningitis may mimic the MR appearance of leptomeningeal metastasis.

开颅术后的患者会出现硬脑膜局限性均匀强化，不要与硬脑膜转移瘤相混淆，其常为厚层、结节样强化。在颅内增强扫描后行脊柱扫描的患者中，在补充一半的对比剂有助于诊断，因为把头部线圈换成脊柱线圈过程中，时间会损失。此外，T1压脂可检查脊柱和软脑膜的疾病。对于未见原发肿瘤的患者，切记感染性、肉芽肿和一些不常见的疾病，比如特发性硬脑膜炎，在MR上与软脑膜转移瘤影像表现相似。