原发性脑内恶性淋巴瘤的MRI研究

MR imaging study of primary malignant lymphomas in the brain

目的 研究脑内原发性恶性淋巴瘤的ＭＲＩ表现，并与恶性胶质瘤和转移瘤进行了对比分析。方法 原发性脑内恶性淋巴瘤４２ 例，其中男２８ 例，女１４ 例，年龄２ ～７５ 岁，平均４０ 岁。４２ 例中，多发８ 例（１９ ％） ，单发３４ 例（８１％ ）。抽取恶性胶质瘤５０ 例、颅内多发转移瘤３０ 例作为对照组。５０ 例胶质瘤中，男３１ 例，女１９ 例，年龄１９～６９ 岁，平均４７－２ 岁。３０ 例转移瘤中，男２３ 例，女７ 例，年龄４４～７２ 岁，平均５３－６ 岁。对两组肿瘤的ＭＲＩ表现进行统计学处理，并对３ 名医师前后２ 次读片进行接受者操作特性（ｒｅｃｅｉｖｅｒｏｐｅｒａｔｉｎｇ ｃｈａｒａｃｔｅｒｉｓｔｉｃ，ＲＯＣ） 曲线分析。４ 例淋巴瘤作为验证组，根据上述统计结果进行诊断，并进行二项分布检验。结果 肿瘤位置是否靠近脑表面或室管膜、肿瘤内囊变坏死灶、边缘是否清晰、Ｔ２ＷＩ信号强度、占位程度、肿瘤增强形态和邻近脑膜、室管膜是否增强等在淋巴瘤组与非淋巴瘤组之间存在着极显著性组间差异（ Ｐ＜ ０－０１） 。Ｌｏｇｉｓｔｉｃ 回归方程中，变量“占位程度”和变量“增强形态”的Ｐ值均＜ ０－０１。２ 次阅片的ＲＯＣ曲线明显不同，Ｐ＜ ０－０１。验证组淋巴瘤?

Objective To study the MR imaging appearances in a series of primary malignant lymphomas in the brain and to compare these findings with those of malignant gliomas and metastasis Methods A retrospective analysis of MR examinations was performed in 42 patients (28 male and 14 female; ranging in age from 2-75 years old; mean age, 40 years) with histologically proved primary malignant lymphomas in the brain, these were then compared with the imaging findings in a non lymphoma group of histologically proved 50 cases (31 male and 19 female; ranging in age from 19-69 years old; mean age, 47 2 years) of malignant gliomas and 30 cases (23 male and 7 female; ranging in age from 44-72 years old; mean age, 53 6 years) of metastasis Another 4 cases were used as the testing group Statistical analysis included χ 2 test, Logistic regression, receiver operating characteristic (ROC) curve and binomial test Results There was significant difference ( P <0 01) between lymphoma group and non lymphoma group in terms of location, cyst formation, margin, T 2WI signal intensity, mass effect, type of enhancement and meningeal enhancement In logistic regression analysis, mass effect and type of enhancement showed significant difference ( P <0 01) between the two groups ROC analysis indicated that there was a significant difference ( P <0 01) at different film reading time In the testing group, 3 cases were diagnosed correctly and one incorrectly Binomial test showed P <0 05 Conclusion Our data indicated that primary malignant lymphomas in the brain had contrast enhancement, mass effect and location characteristics Therefore, it is possible to make preoperative diagnosis using MR and provide reliable information for selecting therapeutic methods