肺腺癌与非腺癌脑转移影像学特征及区域分布的比较分析OA

Objective To analyze the imaging features and regional distribution differences of brain metastases from lung adenocarcinoma and non-adenocarcinoma based on computed tomography(CT)and magnetic resonance imaging(MRI).Methods The clinical data of 102 patients with brain metastases from lung cancer were retrospectively collected.Patients were divided into lung ade-nocarcinoma group(n=52)and non-adenocarcinoma group(n=50)according to the pathological diagnosis.Non-contrast CT,contrast-enhanced CT,and susceptibility-weighted imaging(SWI)were performed using a Siemens dual-source CT scanner and a Philips Ingenia 3.0T MRI scanner.Post-processing techniques including multiplanar reconstruction and maximum intensity projection were em-ployed to analyze the regional distribution,enhancement patterns,and edema extent of brain metasta-ses.General characteristics,metastatic brain regions,and imaging features of brain metastases were compared between the two groups.Variables with P less than 0.05 in univariate analysis were includ-ed in a multivariate logistic regression model to identify independent factors distinguishing the pathologi-cal types.Results Compared with the lung adenocarcinoma group,the non-adenocarcinoma group had a significantly higher proportion of patients with a smoking history,a greater number of brain metastases lesions,and a larger maximum metastasis diameter(P＜0.05).The proportion of brain metastases located in the bilateral cerebral hemispheres was significantly higher,and the proportion in the cere-bellum was significantly lower in the lung adenocarcinoma group than in the non-adenocarcinoma group(P＜0.05).Compared with the non-adenocarcinoma group,the lung adenocarcinoma group had a significantly higher proportion of homogeneous nodular enhancement and significantly lower proportions of ring enhancement and heterogeneous patchy enhancement(P＜0.05).The lung ade-nocarcinoma group also had significantly higher proportions of absent and mild edema and signifi-cantly lower proportions of moderate and severe edema compared with the non-adenocarcinoma group(P＜0.05).Multivariate logistic regression analysis showed that smoking history,the number of brain metastases lesions,maximum metastasis diameter,and edema extent were independent factors distinguishing lung adenocarcinoma from non-adenocarcinoma brain metastases(P＜0.05).Con-clusion CT and MRI imaging demonstrate differences in regional distribution,enhancement pat-terns,and edema extent between brain metastases from lung adenocarcinoma and non-adenocarcino-ma.Smoking history,number of brain metastases,maximum metastasis diameter,and edema extent are independent factors distinguishing the two pathological types.