原发性中枢神经系统淋巴瘤的影像学特征

Imaging features of primary central nervous system lymphoma

目的总结原发性中枢神经系统淋巴瘤(PCNSL)的影像学特征,提高PCNSL诊治水平。方法回顾性分析经病理证实的PCNSL的影像学资料。结果 CT检查病灶多为稍高密度影,MRI检查病灶多为长T1、等或长T2信号影,多数病灶增强扫描为片状均匀强化,MRI增强扫描时会出现"蝴蝶征"等特征性表现,有助于PCNSL的诊断,磁共振波谱表现为Cho峰升高、NAA峰中度降低、Cr轻度降低,出现高大的Lip峰,对鉴别淋巴瘤与其它实性肿瘤具有高度的特异性。结论 MRI在PCNSL的诊断中具有重要作用,掌握PCNSL的特征性影像学特点有助于提高诊断的阳性率。

Objective The clinical and imaging features are discussed to improve the diagnosis and treatment of primary central nervous system lymphoma （PCNSL）. Methods Imaging data of pathologically confirmed PCNSL were retrospectively analyzed, Resdts The typical features of PCNSL on CF were lesions with slightly higher density. Hypointense T1 signal, isointense or hyperintense T2 signal were typical features of PCNSL on MRI. The majority of lesions showed uniform contrast enhancement on Gd-IYFPA MRI. Some typical features such as ＂butterfly sign＂ were helpful in the diagnosis of PCNSL. On MRS, high Cho and Lip peak and low NAA and Cr peak were typical features of PCNSL. Conclusion MRI plays an important role in the diagnosis and treatment of PCNSL. Mastery of typical imaging features of PCNSL will be helpful in the diagnosis and treatment of PCNSL.