Clinical and imaging features of leptomeningeal metastasis from lung adenocarcinoma with non-enhanced T2-fluid attenuated inversion recovery hyperintensity on the brainstem surface
10.3969/j.issn.1002-1671.2024.05.003
- VernacularTitle:非增强T2-液体衰减反转恢复脑干表面高信号肺腺癌软脑膜转移的临床及影像特征分析
- Author:
Xue LIANG
1
;
Zhenyu YIN
;
Yongjuan LIN
;
Qinglei ZHANG
;
Xin ZHANG
;
Bing ZHANG
Author Information
1. 南京大学医学院附属鼓楼医院放射科,江苏 南京 210008
- Keywords:
brainstem;
leptomeningeal metastasis;
lung adeno-carcinoma;
magnetic resonance imaging;
computed tomography
- From:
Journal of Practical Radiology
2024;40(5):697-700
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the clinical and cranial CT/MR features of leptomeningeal metastasis(LM)from lung adenocar-cinoma with non-enhanced T2-fluid attenuated inversion recovery(T2-FLAIR)hyperintensity on the brainstem surface.Methods Eleven cases with LM from lung adenocarcinoma with non-enhanced T2-FLAIR hyperintensity on the brainstem surface confirmed by cere-brospinal fluid cytology were analyzed retrospectively.The clinical features included the pathological classification of the primary tumor,genetic testing results,and treatment methods.The imaging features included lesion location,MRI(T1 and T2)signals,diffusion weighted imaging(DWI)signal,enhancement patterns,CT density characteristics.Results The features of non-enhanced T2-FLAIR hyperintensity on the brainstem surface of 11 cases among 98 patients(11.2％)with LM from lung adenocarcinoma were reviewed.All patients were lung adenocarcinomas with epidermal growth factor receptor(EGFR)gene mutation and were diagnosed with LM after receiving EGFR-tyrosine kinase inhibitors(EGFR-TKIs)targeted therapy.There were 5 cases located in the pons,2 cases in the midbrain and pons,and 4 cases involving the midbrain,pons and medulla oblongata with the symmetrical band-like high signal on non-enhanced T2-FLAIR imaging.On T1WI,1 case showed slightly high signal,10 cases showed equal signal.On DWI,4 cases showed high signal,7 cases showed equal signal,and on enhanced T1WI,1 case showed mild enhancement,and 10 cases showed no enhancement.Additionally,on cranial CT scans,1 case showed calcification on the brainstem.Conclusion Non-enhanced T2-FLAIR hyperintensity on the brainstem surface may be more common among LM patient from lung adenocarcinoma with EGFR gene muta-tions and TKIs treatment,with the most frequent site being the pons.The features may include non-enhanced T2-FLAIR high signal,non-enhancement on enhanced T1 WI,restricted diffusion on DWI,and calcifications on CT imaging.
