Ginaldi S, Wallace S, Shalen P, Luna M, Handel S
AJR Am J Roentgenol. 1981 Jan;136(1):145-9. doi: 10.2214/ajr.136.1.145.
Two hundred seventy-five cranial computed tomography (CT) scans performed on 179 patients with malignant melanoma were reviewed. Of the 101 patients with confirmed cerebral metastases, CT demonstrated lesions in 93. In 72% of these, areas of increased attenuation were present in the precontrast scan. These lesions also enhanced after contrast infusion. There was a direct correlation between the extent of bleeding in the neoplasm and the density of the metastasis, at least 20% red blood cells per high power field were consistently present within lesions of increased attenuation. Cerebral metastases were occasionally associated with subdural or intracranial hemorrhage. Meningeal melanomatosis was recognized by CT only when associated with adjacent parenchymal metastases. In nine (11%) of 74 patients without clinical evidence of brain involvement, CT revealed cerebral metastases; this suggests that a staging CT scan might be useful on patients with diffuse or advanced local extracranial disease prior to definitive therapy.
对179例恶性黑色素瘤患者进行的275次头颅计算机断层扫描（CT）进行了回顾。在101例确诊为脑转移的患者中，CT在93例中显示出病变。其中72%在平扫时出现密度增高区域。这些病变在注入造影剂后也有强化。肿瘤内出血程度与转移灶密度之间存在直接相关性，在密度增高的病变中，每高倍视野至少始终存在20%的红细胞。脑转移偶尔与硬膜下或颅内出血相关。仅当脑膜黑色素沉着症与相邻实质转移相关时，CT才能识别。在74例无脑部受累临床证据的患者中，有9例（11%）CT显示有脑转移；这表明在确定性治疗前，分期CT扫描可能对弥漫性或晚期局部颅外疾病患者有用。
