CT与MRI在中枢神经系统脱髓鞘假瘤与淋巴瘤诊断中的价值分析

Value analysis of CT and MRI in the diagnosis of demyelinating pseudotumor and lymphoma of central nervous system

目的 比较CT与磁共振成像(MRI)在中枢神经系统脱髓鞘假瘤与淋巴瘤鉴别诊断中的应用价值及准确率。方法 68例中枢神经系统脱髓鞘假瘤与淋巴瘤鉴别诊断患者为研究对象,分别对患者实施MRI诊断和CT诊断,对比两种诊断方法的诊断准确率及影像学特征。结果 MRI诊断准确率为97.06%(66/68), CT诊断准确率为79.41%(54/68)。MRI诊断准确率高于CT诊断,差异有统计学意义(χ2=19.221, P<0.05)。中枢神经系统脱髓鞘假瘤:CT诊断影像学特征显示:病灶组织多见低密度影,边界清楚,周围无钙化、囊变情况。MRI诊断影像学特征显示:病灶边缘清晰, T1WI和T2WI模式呈现高信号,扫描增强后多呈“梳齿样”强化。中枢神经系统淋巴瘤:CT诊断影像学特征显示:病灶组织常见等(高)密度影,以中心型强化为主。MRI诊断影像学特征显示:T1WI呈等(高)信号,扫描增强后呈均匀强化特点,表现为“缺口征”、“尖角征”。结论 MRI技术在中枢神经系统脱髓鞘假瘤与淋巴瘤鉴别诊断中的临床价值优于CT诊断,所以在该病诊断过程中应该优先选择MRI进行鉴别。

Objective To compare the application value and accuracy of CT and magnetic resonance imaging(MRI)in the diagnosis of demyelinating pseudotumor and lymphoma of central nervous system.Methods 68 patients requiring differential diagnosis of central nervous system demyelinating pseudotumor and lymphoma of central nervous system were studied,and MRI and CT diagnosis were performed on the patients to compare the diagnostic accuracy and imaging features of the two diagnostic methods.Results The diagnostic accuracy of MRI was 97.06%(66/68),and the diagnostic accuracy of CT was 79.41%(54/68).The diagnostic accuracy of MRI was higher than that of CT,and the difference was statistically significant(χ2=19.221,P<0.05).Demyelinating pseudotumor of the central nervous system:CT imaging features showed that low-density shadows were often seen in the lesion tissue,with clear borders and no surrounding calcification or cystic changes;MRI imaging features showed that the lesions had clear edges,high signal in T1WI and T2WI patterns,and"comb-tooth-like"enhancement after scan enhancement.Lymphoma of the central nervous system:CT imaging features showed that the focal tissues were commonly iso/high-density shadows,mainly central enhancement;MRI imaging features showed that the lesions had iso(high)signal in T1WI,uniform enhancement characteristics after scan enhancement,manifested as"notch sign"and"sharp angle sign".Conclusion The clinical value of MRI technique in the differential diagnosis of central nervous system demyelinating pseudotumor and lymphoma is superior to that of CT diagnosis,so MRI should be preferred for the differential diagnosis of this disease.