颅内原发性中枢神经系统淋巴瘤的MRI诊断

MRI Diagnosis of Intracalvarium Primary Central Nervous System Lymphoma

目的探讨颅内原发性中枢神经系统淋巴瘤(Primary Central Nervous System Lymphoma,PCNSL)的MRI特征及病理学表现,以提高对该病的诊断准确性。方法回顾性分析经病理证实的15例颅内的PCNSL的MRI特征。所有病例均行MR平扫加增强扫描。结果 10例为单发,5例多发。肿瘤多呈类圆形、浅分叶状或无固定的形态;MRI平扫T1WI上呈等或稍低信号,T2WI呈稍低、等或稍高信号;1例可见大片状长T1长T2囊变坏死区。增强扫描病灶多明显均匀强化,呈团块状、结节状、片絮状或无固定的形状,边缘不规整;1例呈环形强化,内部囊变坏死区无强化。5例可见"缺口征"、"脐凹征",1例见"尖角征"。结论颅内PCNSL的MRI表现具有一定的特征性,仔细分析可提高其诊断准确性。

Objective The purpose of this study was to present characteristic MRI findings of intracalvariurn primary central nerw）us system lymphoma with pathological findings, so as to avoid the misdiagnosis and improve the diagnosis of disease. Materials and Methods pathologtcally MRI characteristic in 15 patients pathologicall proved intracalvarium primary central nervous system lymphoma were analyzed. All of 15 cases were examed both plain and enhanced MRI scans. Results 10 patients with single lesion were found and 5 patients with multiple lesions. The lesions were presented circular and shallow lobulated or no fixed form. The masses were slight hypointensity or isointensity signal on T1WI and slight hypointensity or isointensity or hyperintensity signal on T2WI. 1 case were shown large patch capsule and necrotic area. Most masses showed moderately to markedly homoge- neous mass-like enhancement or nodular enhancement or flocculent enhancement or without fixed shape after injection of intraveneous contrast material. I case showed garland-like enhancement. The gap sign and cusp sign were showed 5 and 1 case respectively. Conclusion lntracalvarium primary central nervous system lymphoma have characteristic appearante on MRI,and combined with clinical data can provide more comprehensive information and improve the diagnosis of these tumors.