Kaduri S, Tampieri D
McGill University Health Centre; Montreal, Canada -
Neuroradiol J. 2012 Nov;25(5):587-92. doi: 10.1177/197140091202500512. Epub 2012 Nov 9.
Brain metastases from soft tissue sarcomas (STS) occur late and relatively rarely, most commonly after lung metastases have developed. Furthermore, they are most commonly intraparenchymal in distribution. We describe two cases of histologically confirmed intracranial metastatic soft tissue leiomyosarcomas. In both cases all the nodular metastases measuring 10 mm in diameter or less could be easily detected in the leptomeningeal spaces by MRI. However, as the lesion enlarges it is difficult to recognize the site of origin, and the mass appears and behaves as intra-axial. Lesions located in the leptomeningeal spaces and in the perivascular space can be extremely small, which makes their detection problematic. For this reason we believe that in this context, MRI global gadolinium enhanced imaging using contiguous 1 mm slice thickness acquisition (TR 23 ms,TE 8 ms 512×512 matrix) is preferable, since the patient's management may vary depending on the multiplicity and location of the lesions.
软组织肉瘤（STS）的脑转移发生较晚且相对少见，最常见于肺转移发生之后。此外，它们在分布上最常见于脑实质内。我们描述了两例经组织学证实的颅内转移性软组织平滑肌肉瘤病例。在这两例中，所有直径10毫米或更小的结节性转移灶通过磁共振成像（MRI）在软脑膜间隙中都很容易被检测到。然而，随着病变增大，很难识别其起源部位，肿块表现为轴内病变。位于软脑膜间隙和血管周围间隙的病变可能极小，这使得它们的检测存在问题。因此，我们认为在这种情况下，采用连续1毫米层厚采集（重复时间23毫秒，回波时间8毫秒，512×512矩阵）的MRI全脑钆增强成像更为可取，因为根据病变的数量和位置，患者的治疗方案可能会有所不同。
