脑内原发淋巴瘤的MRI诊断价值

MRI diagnosis of primary lymphoma in the brain

目的 :探讨脑内原发淋巴瘤的MRI特征。方法 :回顾性分析 16例经手术和病理证实的脑内原发淋巴瘤的MRI表现。结果 :脑内原发淋巴瘤MRI表现为 :①肿瘤单发或多发 ,以幕上分布为主 ;②形态类圆形成不规则形 ,T1 WI呈低信号 ,T2 WI呈高或等信号 ,信号均匀 ,DWI呈高信号 ;③瘤周水肿及占位效应较轻 ;④增强扫描肿瘤明显均匀强化 ;⑤可侵及软脑膜和 /或室管膜并沿之播散 ;⑥肿瘤对放疗和化疗敏感 ;形态、大小变化显著。结论 :脑内原发淋巴瘤的MRI增强扫描形态、占位效应以及肿瘤的发生部位具有一定特征 ,在多数情况下可作出诊断并为临床治疗方法的选择提供依据。

Objective:To discuss MRI features of primary lymphoma in the brain.Methods:16 cases of primary lymphoma in the brain proved by operation and pathology were examined by MRI before operation. MRI features were analyzed retrospectively. Results:MRI features of primary lymphoma were as follows:①single or multiple lesions,mostly in supratentorial region;②round or irregular in shape, hypointense on T 1WI,hyperintense or isointense on T 2WI and hyperintense on DWI with homogenous signal;③mild edema around the lesion with mild space occupying effect;④remarkable enhancement of the lesion;⑤involvement of leptomeninges and/or dissemination via ventricular ependyma;⑥sensitive to chemotherapy and radiotherapy.Conclusion:Primary malignant lymphoma in the brain has some specificity in enhanced pattern, space occupying effect and location, which is helpful for the diagnosis and treatment planning.