MRI对原发性中枢神经系统淋巴瘤的诊断价值

Diagnostic value of MRI in primary central nervous system lymphoma

目的探讨脑内原发性中枢神经系统淋巴瘤(PCNSL)的MRI特征,以提高其术前的诊断水平。方法回顾性分析15例经手术后病理证实的PCNSL的MRI表现。结果所有病例均为弥漫大B细胞淋巴瘤;单发11例,多发4例;共19个病灶,其中幕上15个,幕下4个;圆形或类圆形为主,占位效应轻,轻、中度水肿占73.6%;T1WI呈相等或稍低信号,T2WI示大部分病灶为相等或稍高信号,少数病灶为高信号,FLAIR上为相等或稍高信号,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PCNSL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,对PCNSL的发现具有一定的提示作用。

Objective To explore the MRI characteristics of primary central nervous system lymphoma（ PCNSL） so as to improve it＇s preoperative diagnosis Methods The MRI data from 15 PCNSL confirmed by pathological findings after surgery were retrospectively analyzed. The location, morphology and signals of the lesions were studied. Resutls All patients were diagnosed as diffuse large B cell lymphoma. A total of 19 lesions were presented in 15 patients,4 patients had multiple lesions. 15 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（73.6% ） and slight space-occupying effect. On plain MRI scans, all lesions presented as slight hypo-or isointensity on T1WI ,whereas on T2WI and FLAIR images, most lesions were iso-or slight hyperintensity. Most of the lesions were obviously homogeneous enhanced when MRI scans were strengthened. Conclusions The MRI imaging find- ings of PCNSL has some specificity, it has some hint role for PCNSL diagnosis after analyzing these imaging manifestation and clinical data carefully.