颅内原发淋巴瘤的CT和MRI表现

CT and MR imaging appearances of intracrebral primary lymphoma

目的通过分析颅内原发淋巴瘤的影像表现,以提高诊断水平。方法回顾22例临床确诊的颅内原发淋巴瘤的影像资料,分析病灶的分布、形态、信号特点及强化特征。结果MRI显示14例为单发,8例为多发,主要病灶共40个,均位于幕上,其中位于大脑半球深部14个,灰白质交界区5个,累及胼胝体13个,基底节区及丘脑区8个。其中各有2例累及软脑膜及室管膜。病灶形态多为类圆形、团块或不规则状,边界较清晰,瘤周水肿及占位效应较轻。病灶T1WI呈等或略低信号,T2WI为等或略高信号。CT上病灶表现等密度或稍高密度22个,低密度18个。增强后所有病灶呈团块状或环状显著强化。结论颅内原发淋巴瘤CT、MRI表现及强化形式具有一定特征性,但仍须结合临床才能有效提高诊断准确率。

Objective To analyze the imaging appearances of intracranial primary lymphoma （IPL） for better diagnosis. Method The 22 cases diagnozed as IPL through clinical and pathologic tests were retrospectively analyzed in regard to appearance, location, signal and enhanced features. Results On MR images,single lesions were found in 14 cases and multiple ones in 8.Among the 40 lesions of 22 cases, 14 located in deep brain tissue, 5 in white-gray matter junction,8 in basal ganglia and cerebral ganglion,13 in corpus callosum, meningina or endyma infiltration was found in 4 lesions. The location of all lesions was in the supratentorial site. Most tumors presented as round-like mass with well margin or anomalism with slight para-tumor edema and space-occupying effect. On T1WI, the lesions were isointense or slight hypointense signal while on T2WI those were isointense or slight hyperintese signal. On CT images, 22 lesions were isodense or slight high density, 18 were low density. Following Gd- DTPA administration,the lesions presented obviously mass-like or annuliform enhancement. Conclusion IPL has certain features in imaging appearance and enhancement pattern; but only combined with clinical manipulations effectively enhancing diagnosis acouracy in just obtained.