中枢神经系统淋巴瘤的不典型MRI表现

Atypical MRI Manifestations of Central Nervous System Lymphoma

目的分析中枢神经系统淋巴瘤(central nervous system lymphoma,CNSL)的不典型MRI表现,增加对中枢神经系统淋巴瘤不典型MRI表现的认识。方法回顾性分析北京市大兴区人民医院与大连医科大学附属第二医院经手术或穿刺病理活检证实的23例不典型中枢神经系统淋巴瘤MRI资料,通过发病部位、病灶信号、强化方式以及周围水肿程度分析其特征。结果23例患者共有病灶58个,10例多发,13例单发。不典型的发病部位(大脑半球表浅区11个、小脑半球10个、脑室内4个);不典型表现主要为:病灶内信号(出现坏死21个,出血1个,DWI信号:7个表现为等低信号,3个表现为混杂信号);强化方式(22个病灶不均匀强化,其中12个病灶表现为环形强化);肿瘤周围水肿(重度18个)。结论中枢神经系统淋巴瘤不典型MR表现可以表现为部位、信号、水肿、强化等各个方面,随着中枢神经系统淋巴瘤的发生率增加,正确认识其不典型表现有助于提高诊断的准确率。

Objective Atypical MRI manifestations of central nervous system lymphoma(CNSL)were analyzed to increase awareness of atypical MRI manifestations in central nervous system lymphoma.Methods The MRI data of 23 atypical central nervous system lymphomas confirmed by surgery or biopsy in our hospital were retrospectively analyzed.The MRI manifestations including the location,the signals in the lesions,the characteristics of pre-contrast and post-contrast MR signal intensity and the degree of surrounding edema were evaluated.Results Twenty-three patients had a total of 58 lesions,10 with multiple lesions and 13 with single lesions.The atypical locations(11 superficial regions of the cerebral hemisphere,10 cerebellar hemispheres,4 in the cerebral ventricle);the atypical manifestations were as following:intralesional signals(21 necrosis,1 bleeding;DWI signal:7 showed equal low signal,3 showed mixed signal);enhancement mode(22 lesions were unevenly enhanced,12 of which showed ring enhancement);edema around the tumor(18 showed severe edema).Conclusion The atypical MR manifestations of central nervous system lymphoma can be manifested as parts,signals,edema and enhancement.With the increase of the incidence of central nervous system lymphoma,a correct understanding of its atypical performance can improve the accuracy of diagnosis.