原发性脑淋巴瘤的CT和MRI影像特点分析

Analysis of the CT and MRI Imaging Features of Primary Brain Lymphoma

目的分析原发性脑淋巴瘤的CT和MRI影像特点,为其更好的明确诊断做出帮助。方法对2005年3月至2013年6月确诊为原发淋巴瘤的20位患者进行回顾性分析,分析患者的MRI和CT影像特点。结果患者中,病灶单发15例,多发5例。位置全脑均发。幕上18例,幕下2例。病灶平均(2.6×2.5×2.3)cm。在CT断层图像上,病灶多为圆形,类圆形,边界清楚,大小一般在直径2cm左右,较好分辨。CT图像上来看,患者颅内肿块平扫多为等密度或者高密度,在接受检查的20名患者中,14例为高密度肿块。进一步对20名患者进行增强扫描,20例全部强化,18例是均匀而明显强化;2例为环形明显强化;MRI上,病灶边界清楚,信号均匀,TIWI上为等、低信号,T2WI上为稍高信号或是等信号,增强多均匀,其中有2例不均匀强化和2例硬膜尾征。病理结果20例均为B细胞型非何杰金氏淋巴瘤(NHL)。结论CT和MRI在对原发性脑淋巴瘤的诊断中可以起到一定作用,但是确诊较难,还是要依靠病理检查。

Objective To study the CT and MRI features of primary brain lymphoma, then help to better diagnose. Methods From 2005 March to 2013 June, 20 patients with primary lymphoma were selected to retrospectively analyzed of the MRI and CT imaging features of patients. Results In these patients, 15 cases with single lesion and 5 cases multiple. The whole brain position were made. 18 cases of supratentorial, and 2 cases of infratentorial . The mean lesion was （2.6×2.5 × 2.3） cm. On CT tomography images, the lesion was round, like round, clear boundary, size was generally 2 cm in diameter, had better resolution. In CT images, patients with intracranial mass scan for the density or high density, in 20 patients examined, 14 cases of high density mass. The 20 patients were enhanced scanning, 18 cases of all 20 cases was strengthened, uniform and enhanced obviously; 2 cases of annular enhancement; On MRI lesions, it showed clear boundary, homogeneous signal, TIWI for low signal, T2WI is slightly high signal or signal enhancement, uniform, including inhomogeneous enhancement in 2 cases and 2 cases of dural tail sign. Pathological results of 20 cases were B cell non Hodgkin＇s lymphoma （NHL）. Conclusion CT and MRI in the diagnosis of primary brain lymphoma can play a certain role, but the diagnosis is difficult, or to rely on pathological examination.