Habets J M, van Oosterhout A G, ten Velde G P, Wilmink J T, Twijnstra A
Department of Neurology, University Hospital, Maastricht, The Netherlands.
J Belge Radiol. 1992 Jun;75(3):179-81.
Fifty-seven patients with histologically proven small cell lung carcinoma were prospectively evaluated for signs of brain metastasis by neurological examination and computerized tomographic (CT) brain scanning. The reliability of demonstrating brain metastases by means of neurological examination was compared with that of CT. Three (5%) patients, two with cerebrovascular infarcts and one with leptomeningeal metastases, were excluded from the study. Four (7%) patients, all with extensive disease, showed neurological symptoms and signs of brain metastases, which were confirmed in three cases by brain CT. The fourth patient had neurological symptoms and signs pointing to cerebral metastasis, but no sign of this was detected on CT at the time of diagnosis. However, six months later, after completion of chemotherapy, CT revealed signs of brain metastasis. The other fifty neurologically asymptomatic patients had no brain metastases on CT. This clinical study suggests that routine CT of the brain is not useful in neurologically asymptomatic patients with small cell lung carcinoma.
对57例经组织学证实的小细胞肺癌患者进行前瞻性评估，通过神经系统检查和脑部计算机断层扫描（CT）来检测脑转移迹象。将通过神经系统检查发现脑转移的可靠性与CT的可靠性进行比较。三名（5%）患者被排除在研究之外，其中两名患有脑血管梗死，一名患有软脑膜转移。四名（7%）患者均患有广泛期疾病，表现出脑转移的神经系统症状和体征，其中三例经脑部CT证实。第四名患者有指向脑转移的神经系统症状和体征，但诊断时CT未发现此迹象。然而，六个月后，化疗结束后，CT显示有脑转移迹象。其他50名无神经系统症状的患者CT检查未发现脑转移。这项临床研究表明，对于无神经系统症状的小细胞肺癌患者，常规脑部CT检查并无用处。
