原发性中枢神经系统淋巴瘤的1H-MRS及PWI研究

Magnetic Resonance Spectroscopy and Perfusion-weighted Imaging Study in Primary Central Nervous System Lymphoma

目的探讨1H-MRS及PWI对原发性中枢神经系统淋巴瘤(PCNSL)的诊断价值。方法从2005年8月至2011年11月,回顾性分析17例经手术或者穿刺病理证实的PCNSL行MRI扫描,其中16患者1H-MRS扫描,9例患者行PWI扫描。结果 16例患者1H-MRS表现:肿瘤实质区Cho峰升高100%(n=16/16),NAA峰降低100%(n=16/16),Cr峰轻度降低94%(n=15/16),Lip峰或Lip与Lac的复合峰出现100%(n=16/16)。11例患者的肿瘤实质区的PWI提示皆为低灌注。结论常规磁共振成像、1H-MRS、灌注加权成像的联合应用可以提高原发性中枢神经系统淋巴瘤的诊断与鉴别诊断水平。

Objective To discuss the diagnostic value of Magnetic Resonance Spectroscopy （1H-MRS） and perfusion-weighted imaging thr Primary central nervous system lymphoma （PCNSL）. Methods Seventeen consecutive patients （male [n = 11], female [n = 7]） with histopathologically proven PCNSL were retrospectively evaluated during this study from August 2005 to November 2010. All patients were histopathologically confirmed to have lymphoma by biopsy and surgery. All patients had regular magnetic resonance imaging （MRI） examination, proton-MR-spectroscopy （1 H-MRS） was available in 16, perfusion- weighted magnetic resonance imaging（PWI）in 11 patients. Results MR spectroscopy dem- onstrated an increase in choline（Cho） in 100% （n = 16/16）. Decrease in NAA was noted in all cases （n = 16/16, 100%）. Decrease in creatine （Cr） was also noted in 94% （n=15/16）. Presence of either an lipid（Lip） or a lipidqactate peak was present in 100%（n = 16/16）.PWI displayed low perfusion in all cases（n = 11）. Conclusion Conventional MR imaging com- bined with 1H-MRS and PWI can improve diagnostic and differential diagnostic accuracy of PCNSL.