DISTRIBUTION OF BRAIN METASTASES
DISTRIBUTION OF BRAIN METASTASES
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DOI：
10.1001/archneur.1988.00520310047016
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发表时间：
1988-07-01
影响因子：
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通讯作者：
POSNER, JB
中科院分区：
文献类型：
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作者：
DELATTRE, JY;KROL, G;POSNER, JB
通过288名患者的计算机断层扫描确定了脑转移瘤的数量和部位。49%的扫描中有一个脑转移，21%有两个，13%有三个，6%有四个，11%有五个或更多。在有一个转移的患者中，当原发肿瘤是盆腔（前列腺或子宫）或胃肠道时，50%的患者累及后颅窝，但只有10%的患者累及其他原发肿瘤。半脑转移瘤偏好解剖学上的“分水岭区域”（29%的脑表面包含37%的转移瘤），表明肿瘤微栓子倾向于滞留在浅动脉远端部分的毛细血管中。134例原发于肺外的肿瘤脑转移患者的图表显示，无论原发肿瘤是盆腔或胃肠道还是其他部位，肺和脊柱转移的发生率相同。这些数据表明，在盆腔和胃肠道原发性肿瘤患者中幕下病变的高发病率不能仅用动脉栓塞来解释，这种特殊的分布可能不能用通过Batson神经丛的脑种植来解释。
The number and site of brain metastases were identifed on the computed tomographic scans of 288 patients. There was one brain metastasis in 49%, two in 21%, three in 13%, four in 6%, and five or more in 11% of scans. In patients with one metastasis, the posterior fossa was involved in 50% of patients when the primary tumor was pelvic (prostate or uterus) or gastrointestinal, but it was involved in only 10% of patients with other primary tumors. Hemispheral metastases preferred the anatomic "watershed areas" (29% of the brain surface contained 37% of the metastases), indicating that tumoral microemboli tend to lodge in the capillaries of the distal parts of the superficial arteries. The charts of 134 patients with brain metastases from a primary tumor originating outside the lung revealed that the incidence of lung and spine metastases was the same, whether the primry tumor was pelvic or gastrointestinal or from another site. These data suggest that the high incidence of subtentorial lesions in patients with pelvic ad gastrointestinal primary tumors cannot be explained by arterial embolization alone, and that this peculiar distribution is probably not explained by seeding of the brain through Batson''s plexus.