原发性脑淋巴瘤与脑膜瘤的影像表现及病理对照分析

Comparative study of primary cerebral lymphoma and meningeoma on imaging and pathology

目的:对照分析原发性脑淋巴瘤与脑膜瘤的影像表现及病理特征。方法:回顾性分析经病理证实的10例原发性脑淋巴瘤和30例脑膜瘤的CT、MRI及病理资料。结果:10例原发性脑淋巴瘤,单发病灶6例,多发病灶4例。肿块位于深部脑组织8例,位于脑膜表浅组织2例,1例出现囊变坏死区,6例出现握拳征,1例出现脑膜尾征,肿块均无钙化灶。DWI均呈现高信号。病理类型均为B细胞型非霍奇金淋巴瘤。30例脑膜瘤均为单发病灶。肿块位于深部脑组织7例,位于脑膜表浅组织23例。14例形成脑膜尾征,5例出现囊变坏死区,12例出现钙化灶,未出现握拳征。DWI呈现低信号6例,等信号10例,高信号14例。病理类型均为脑膜瘤。通过统计学分析发现,两者在肿块单发多发、好发部位、脑膜尾征、钙化灶、握拳征、DWI信号方面差异具有统计学意义(P<0.05)。结论:原发性脑淋巴瘤与脑膜瘤的影像表现各有特征,但也有类似之处,仔细分析影像学表现能提高准确率,明确诊断需依据术后病理。

[ Objective] To comparatively study the imaging features and pathological characteristics of primary cerebral lymphoma and meningeoma. [Method] CT and MRI findings, from 10 patients with pathologically confirmed primary cerebral lymphoma and from 30 patients with pathologically confirmed meningeoma, were comparatively retrospectively analyzed. [ Result] In 10 cases of primary cerebral lymphoma, 6 cases were single and 4 cases were multiple lesions. 8 lesions were located in the deep brain tissue and 2 lesions were located in the meninge superficial tissue. 1 lesion existed cystic necrosis, 6 lesion existed clench fist sign and 1 lesion existed dural tail sign. No case existed calcification. DWI demonstrated hyperintense lesions. The pathological types were diffuse large B cell lymphoma. In 30 cases of meningiomas were single lesion, 7 lesions were located in the deep brain tissue and 23 lesions were located in the meninge superficial tissue. 14 lesions existed dural tail sign, 5 lesions existed cystic necrosis and 12 lesions existed calcification. No case existed clench fist sign. 6, 10 and 14 lesions respectively demonstrated low intensity, iso- intensity and hyper- intense lesions on DWI,. All cases were meningeomas. There were statistically significant difference between primary cerebral lymphoma and meningeoma on lesions＇ number, location, dural tail sign, calcification, clench fist sign and DWI sign. [ Conclusion] Imaging findings of primary cerebral lymphoma and meningeoma have different features, but they had many similar characteristics. The accuracy of diagnosis could be improved via careful analysis of imaging features, and definite diagnosis should be based on postoperative pathology.