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目的探讨脑脊液细胞学检查对脑膜癌病诊断的价值。方法对39例经脑脊液细胞学检查确诊的脑膜癌病患者的临床资料进行回顾性分析。结果本组39例患者以头痛、恶心、呕吐、脑膜刺激征为主要临床表现,常规脑脊液检查以颅内压力增高、蛋白质增高、细胞数轻度增多、氯化物和葡萄糖降低为特点,所有患者脑脊液细胞学检查均显示异常并查到肿瘤细胞;所有患者MRI和CT平扫均未见异常,15例患者行CT或MRI增强扫描仅3例(20%)显示脑膜异常强化,MRV扫描发现1例横窦闭塞。结论脑膜癌病的临床表现、脑脊液常规检查及影像学表现缺乏特异性,脑脊液细胞学检查找到癌细胞是诊断脑膜癌病的重要依据。
Objective To investigate the value of cerebrospinal fluid cytology in the diagnosis of meningeal carcinomatosis. Methods The clinical data of 39 cases of meningeal carcinomatosis diagnosed by cerebrospinal fluid cytology were analyzed retrospectively. Results The main clinical manifestations of 39 patients were headache, nausea, vomiting and meningeal irritation. Conventional cerebrospinal fluid examination was characterized by increased intracranial pressure, increased protein, slightly increased cell number, decreased chloride and glucose, and all patients had cerebrospinal fluid Cytology showed abnormalities and found tumor cells; MRI and CT scan of all patients showed no abnormalities, 15 patients underwent CT or MRI enhanced scan only 3 cases (20%) showed enhanced meningeal abnormalities, MRV scan found in 1 case Transverse sinus occlusion. Conclusion The clinical manifestations of meningeal carcinomatosis, cerebrospinal fluid routine examination and imaging performance of the lack of specificity, CSF cytology to find cancer cells is an important basis for the diagnosis of meningeal cancer.