分析原发性脑淋巴瘤的CT和MRI影像特点

Analysis of CT and MRI Features of Primary Brain Lymphoma

目的:探讨原发性脑淋巴瘤的CT和MRI影像特点。方法:选取2015年7月~2019年6月,在本院治疗的32例原发性脑淋巴瘤患者为研究对象。所有患者均先后进行CT及MRI检查分析CT及MRI检查的病灶形态、特征、大小、分布等指标。结果:B细胞型非霍奇金淋巴瘤27例(84.38%),胶质瘤5例(15.63%)。淋巴瘤患者中,单发18例,多发6例,共34个病灶,大脑半球14个,基底节区7个,胼胝体8个,脑干3个,小脑2个。肿瘤直径7~58mm,平均(36.56±2.71)mm。形态为椭圆形、类圆形、团块状。轻度4例,中度15例,重度13例。MRI检查:T2WI均为高信号,T1WI中等信号27例,低信号5例。增强扫描:明显增强14例,环形增强9例,斑片状增强5例。CT检查:高密度、混杂密度14例,中等密度12例,低密度5例。病灶边缘处理后:无明显增强27例,均匀增强2例,环形增强3例。结合CT及MRI影像,所有患者均初步诊断为淋巴瘤。与病理诊断相比,符合率84.38%。结论:原发性脑淋巴瘤CT及MRI检查影像特征明显,综合两者进行分析,诊断准确率较高,但应注意与脑内其他肿瘤鉴别。

Objective:To investigate the characteristics of CT and MRI images of primary cerebral lymphoma.Methods:Thirty-two patients with primary brain lymphoma treated in our hospital from July 2015 to June 2019 were selected as the research subjects.All patients underwent CT and MRI examinations to analyze the lesion shape,characteristics,size,distribution and other indicators of CT and MRI examinations.Results:There were 27 cases of B-cell non-Hodgkin’s lymphoma(84.38%)and 5 cases of glioma(15.63%).Among patients with lymphoma,18 were single and 6 were multiple.There were 34 lesions,14 in the cerebral hemisphere,7 in the basal ganglia,8 in the corpus callosum,3 in the brain stem,and 2 in the cerebellum.Tumor diameters ranged from 7 to 58 mm,with an average of(36.56±2.71)mm.The shape is oval,quasi-circular,and lumpy.There were 4 mild cases,15 moderate cases,and 13 severe cases.MRI examination:T2 WI showed high signal,T1 WI had moderate signal in 27 cases,and low signal in 5 cases.Enhanced scan:14 cases were significantly enhanced,9 cases were ring-shaped enhancement,5 cases were patchy enhancement.CT examination:high density and mixed density in 14 cases,medium density in 12 cases and low density in 5 cases.After treatment of the edge of the lesion,there were no obvious enhancement in 27 cases,uniform enhancement in 2 cases,and circular enhancement in 3 cases.Combined with CT and MRI images,all patients were initially diagnosed with lymphoma.Compared with pathological diagnosis,the coincidence rate was 84.38%.Conclusion:CT and MRI examinations of primary brain lymphoma have obvious imaging characteristics.Comprehensive analysis of the two has a high diagnostic accuracy,but attention should be paid to distinguishing it from other brain tumors.