原发性中枢神经系统非霍奇金淋巴瘤的影像学特征

Imaging features of primary non-Hodgkin's lymphoma of the central nervous system

目的探讨原发性CNS非霍奇金淋巴瘤(PCNSNHL)的影像学特征。方法回顾性分析12例PCNSNHL患者的临床资料。结果本组患者MRI检查示T1等或低信号,T2等或高信号;占位病灶呈均匀团块样强化,周围水肿,且水肿范围与病变大小不成比例;占位病灶早期动态增强示T1低信号,T2高信号。5例患者行质子核磁共振光谱成像(1H-MRS)示强化区胆碱峰明显升高,N-乙酰天冬氨酸峰明显降低。结论PCNSNHL的MRI主要特征为T1增强出现"尖角征"、"脐凹征"征,或表现为不规则强化;1H-MRS表现为胆碱峰明显升高,N-乙酰天冬氨酸峰明显降低,甚至出现脂质峰。

Objective To explore the imaging features of patients with primary non-Hodgkin＇s lymphoma of the central nervous system （PCNSNHL）. Methods Clinical data of 12 patients with PCNSNHL were analyzed retrospectively. Results MRI showed equal or lower signal on TIWI, and equal or higher signal on T2WI. The space-occupying lesion showed massive homogeneous enhancement and peripheral edema, and the range of edema was disproportionate to lesion size. The dynamic enhanced MRI of space-occupying lesion in early stage showed low signal on T1, high signal on T2. ^1H-magnetic resonance spectroscopy （^1H-MRS） of 5 cases showed choline （Cho） peak of enhanced regions was significantly increased, and N-acetyla spartate （NAA） peak of enhanced regions was significantly decreased. Conclusions MRI features of PCNSNHL are ＂ sharp angle sign＂, ＂ notch sign＂ on enhanced T1, or inhomogeneous enhancement. 1H-MRS shows choline （Cho） peak of enhanced regions is significantly increased, and N-acetyla spartate （NAA） peak of enhanced regions is significantly decreased, even has lipid peak.