南京医科大学学报（自然科学版）2024，Vol.44Issue(6)：812-817,6.DOI:10.7655/NYDXBNSN240089
非小细胞肺癌软脑膜转移患者MR测量与脑脊液压力的相关性研究
Correlation study of MR measurement and cerebrospinal fluid pressure in non-small cell lung cancer patients with leptomeningeal metastasis
摘要
Abstract
Objective:To explore the correlation between magnetic resonance(MR)findings[optic nerve sheath diameter(ONSD)and peripheral cerebrospinal fluid volume/intracranial volume ratio(PCSFV/ICV)]and cerebrospinal fluid pressure(CSFP)in patients with leptomeningeal metastases(LM)from non-small cell lung cancer(NSCLC).And to assess the diagnostic accuracy of combined ONSD and PCSFV/ICV in diagnosing elevated CSFP.Methods:A total of 63 patients with NSCLC-LM were enrolled.Both optic nerve and cranial MR scans were performed to measure bilateral ONSD,cranial PCSFV and ICV.Subsequently,CSFP was measured in all patients through lumbar puncture,and intrathecal chemotherapy was administered regularly.Pearson correlation analysis was used to analyze the correlation between CSFP and MR findings.The accuracy of combined ONSD and PCSFV/ICV in diagnosing elevated CSFP was evaluated through receiver operating characteristic(ROC)curve analysis.Results:In patients with NSCLC-LM,the average ONSD of bilateral eyes was positively correlated with CSFP(r=0.567,P＜0.001).PCSFV/ICV was negatively correlated with CSFP(r=-0.365,P=0.003).ROC curve analysis showed that the performance of ONSD,PCSFV/ICV,and combined ONSD with PCSFV/ICV in diagnosing intracranial hypertension(CSFP＞15 mmHg)were 0.81(95％CI:0.71-0.91),0.76(95％CI:0.64-0.89),and 0.91(95％CI:0.84-0.99),respectively.The performance of ONSD,PCSFV/ICV,and combined ONSD with PCSFV/ICV in diagnosing intracranial hypertension(CSFP＞20 mmHg)were 0.70(95％CI:0.58-0.82),0.72(95％CI:0.57-0.88),and 0.81(95％CI:0.70-0.93),respectively.Conclusion:The utilization of MR for measuring ONSD and PCSFV/ICV provides a valuable means to assess variations in CSFP among patients diagnosed with NSCLC-LM.Additionally,the combination of these two measurements enhances the diagnostic accuracy for evaluating CSFP,demonstrating its potential clinical significance.关键词
脑脊液压力/非小细胞肺癌/软脑膜转移/视神经鞘直径/磁共振Key words
cerebrospinal fluid pressure/non-small cell lung cancer/leptomeningeal metastasis/optic nerve sheath diameter/MR分类
医药卫生引用本文复制引用
何雪颖,林永娟,尹震宇,田传帅,张鑫,梁雪,张冰..非小细胞肺癌软脑膜转移患者MR测量与脑脊液压力的相关性研究[J].南京医科大学学报（自然科学版）,2024,44(6):812-817,6.基金项目
国家自然科学基金(81971596) （81971596）
南京鼓楼医院临床研究专项基金面上项目(2022-LCYJ-MS-25) （2022-LCYJ-MS-25）
