MRI对原发性中枢神经系统淋巴瘤的诊断价值

MRI Diagnosis of Primary Central Nervous System Lymphoma

目的:探讨脑内原发性淋巴瘤的MRI特征,以提高其术前的诊断水平。方法:回顾性分析12例经手术后病理证实的脑内原发性淋巴瘤的MRI表现。结果:所有病例均为弥漫大B细胞淋巴瘤。单发10例,多发2例,共16个病灶,其中幕上12个,幕下4个。圆形或类圆形为主,占位效应轻,轻或中度水肿(75.0%)。在T1WI上呈等或稍低信号,在T2WI上大部分病灶为等或稍高信号,少数病灶为高信号,FLAIR上为等或稍高信号。增强后大部分明显均匀强化,少部分病灶内可见无强化的坏死区。结论:中枢神经系统原发性淋巴瘤的MRI表现具有一定的特征性,结合特定的发病部位和发病年龄,大部分可以获得正确的术前诊断。

Objective： To explore the MRI characteristics of primary central nervous system lymphoma so as to improve it＇s presurgical diagnosis. Methods： The MRI data from 12 primary central nervous system lymphoma confirmed by surgery were retrospectively analyzed. The location, morphology and signals of the lesions were studied. Results： All patients were diagnosed as diffuse large cell lymphoma B cell. A total of 16 lesions were present in 12 patients, 2 patients （16.7%） had multiple lesions.12 lesions were located at the supratentoria region, and the other 4 were in the inferior tentorium region. Usually, the lesion was presented as an oval mass with slight peritumoral edema （75.0%）and slight space-occupying effect.On plain MRI scans, all lesions presented as slight hypo- or isointensity on T1WI,and on T2WI and FLAIR images, most lesions were iso- or sligh hyperintensity. Most of the lesions were obviously homogeneous enhanced. Conclusions： The MRI imaging findings of primary central nervous system lymphoma has some specificity, it is possible to give a definite diagnosis after analyzing these imaging manifestation and clinical data carefully.