Figen KADAKAL, Mehmet Atilla UYSAL, Mehmet Akif ÖZGÜL, Banu ALTOPARLAK, Hakan CİNEMRE, Veysel YILMAZ

Küçük hücreli dışı akciğer kanseri beyin metastazı tanısında bilgisayarlı beyin tomografisi ve manyetik rezonans görüntüleme yönteminin karşılaştırılması

Çalışmamızda, nörolojik semptom olsun veya olmasın, küçük hücreli dışı akciğer kanseri (KHDAK) olan hastaların beyin metastazlarının tespitinde, beyin bilgisayarlı tomografi (BT) ve manyetik rezonans görüntüleme (MRG)’yi eş zamanlı kullanarak her iki görüntüleme yönteminin yerini değerlendirmeyi amaçladık. Ocak 2000-Aralık 2003 tarihleri arasında hastanemize KHDAK tanısı ile başvuran 62 hasta (58’i erkek, 4’ü kadın) çalışmaya alındı. Hastaların yaşları 40-85 (61 ± 11) yıl arasında değişmekteydi. Tüm hastalara tam kan sayımı ve biyokimya, akciğer grafisi, toraks BT, beyin BT, beyin MRG, fiberoptik bronkoskopi ve tam nörolojik muayene yapıldı. Altmışiki hastanın 8 (%12.9)’inde BT ile beyin metastazı tespit edilmiş olup, bu olguların 4 (%50)’ünde nörolojik muayenede bulgu ve semptomlar mevcut değildi. Altmışiki hastanın 22 (%35.5)’sinde beyin MRG metastaz tespit edilmiş olup, bu hastaların 16 (%72.7)’sında nörolojik bulgu ve semptom yoktu. MRG ile BT arasında beyin metastazı tespit etmede istatistiksel olarak fark anlamlıydı (p< 0.01). MRG ile beyin metastazı tespit edilen 22 olgunun 9 (%14.5)’u evre I olgularıydı. Beyin BT ile tek metastaz tespit edilen beş olgudan 4 (%80)’ünde multipl metastaz tespit edilmiştir. KHDAK’lı hastaların doğru evreleme ve tedavisinde; erken evre dahil olmak üzere, nörolojik bulgu olsun veya olmasın, beyin metastazı incelemesinde, beyin MRG’nin kullanılmasının beyin BT’ye göre daha üstün bir yöntem olduğunu düşünmekteyiz.

Comparison of computed tomography and magnetic resonance imaging to diagnose brain metastasis in non-small cell lung cancer

To investigate the value of simultaneously obtained brain computed tomogrophy (CT) and magnetic resanance imaging (MRI) to diagnose brain metastasis in non-small cell lung cencer (NSCLC) patients with or without neurological symptoms. Sixty-two patients (58 male, 4 female) who were admitted to Yedikule Chest Hospital and Thoracic Surgery Center between January 2000-December 2003 and whom were diagnosed with NSCLC were included in the study. Ages of patients varied between 40-85 (61 ± 11). All patients had hemogram and routine blood chemistry as well as chest X-ray, thorax CT, brain CT, brain MRI, FOB and a complete neurological exam. Brain metastasis were detected in 22 of 62 (35.5%) patients by using brain MRI and 16 (72.7%) of these hadn’t had any neurological symptoms or signs. The difference to detect the brain metastasis between brain MRI and CT was statistically significant (p< 0.01). Nine of the 22 cases (14.5%) who were found to have brain metastasis by using MRI were stage I. While brain CT showed solitary brain metastasis in five patients, 4 (80%) of them were found to have multiple metastases when MRI studies were used. We concluded that, in an attempt to make correct staging and treatment of NSCLC and hence to investigate the brain metastasis in NSCLC patients including early stage ones, brain MRI is superior to brain CT study.

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