MRI和CT在中枢神经系统淋巴瘤诊断中的应用价值

Application value of MRI and CT in the diagnosis of central nervous system lymphoma

目的探讨CT及MRI在原发性中枢神经系统淋巴瘤中的应用价值。方法选择经病理证实的原发中枢神经系统淋巴瘤患者39例，所有患者均接受多层螺旋CT及MRI检查。观察淋巴瘤的影像学特点，比较各感兴趣区（RIO）中NAA／Cho、NAA／Cr、Cho／Cr、Lip／Cr及ADC值的不同。结果原发性中枢神经系统淋巴瘤病变的好发部位包括额叶、顶叶及基底节区。CT图像主要表现为等或略高密度，MRI图像中表现为等或略长T1、等或略长，T2信号，DWI呈等、略高或高信号，肿瘤实质均呈明显强化。淋巴瘤肿瘤实质区出现高耸的Lip峰及Cho峰升高，NAA峰及Cr峰明显降低，肿瘤实质区Cho／NAA、Cho／Cr、NAA／Cr及Lip／Cr均显著高于瘤周水肿区及健侧对照区，其ADC值显著低于瘤周水肿区及健侧对照区（P〈0．05）。结论在原发中枢神经系统淋巴瘤的诊断中，多层螺旋CT与MRI可以清晰显示肿瘤的形态、密度／信号特点及代谢情况，具有较高的应用价值。

Objective To investigate the application value of CT and MRI in the diagnosis of primary central nervous system lymphoma. Methods Thirty-nine cases of primary central nervous sys-tem lymphoma patients who had been confirmed by pathology, all of them have received muhislice spiral computed tomography and magnetic resonance imaging tests. Observed lymphoma＇ s imaging characteris- tics, compared differences among NAA/Cho, NAA/Cr, Cho/Cr, Lip/Cr and ADC values. Results Primary central nervous system lymphoma＇ s primary sites including frontal lobe, parietal lobe and basal ganglia. CT imaging showed equal or slightly high density, MRI imaging showed equal or slightly long T1, equal or slightly long T2, DWI equal, slightly high or high signal, tumor essence strengthened signifi- cantly. Towering Lip peak and increasing Cho peak occurred in lymphoma tumor essence area, NAA peak and Cr peaks decreased obviously in the same area, tumor essence area＇ s Cho/NAA, Cho/Cr, NAA/Cr and Lip/Cr values were obviously higher than health side control area＇ s （ P 〈 0.05 ）. Conclusions In the diagnosis of primary central nervous system lymphoma, muhislice spiral computed tomography and magnetic resonance imaging can display tumor＇ s form, density, signal characteristics and metabolic situ- ation, they have superior application value.