摘要
目的:描述原发性中枢神经系统淋巴瘤的MRI表现,探讨MRI对该病的诊断价值。材料和方法:回顾性分析10例经手术病理证实的原发性中枢神经系统淋巴瘤的MRI表现。结果:10例均为弥漫大B细胞型非霍奇金淋巴瘤。5例为单发,5例为多发,共16个病灶,其中大脑半球8个,基底节4个,右侧背侧丘脑及基底节1个,脑室内3个。10例病变均表现为局灶性肿块,6例边界较清楚,4例边界不甚清楚。T1WI呈稍低或等信号;T2WI呈等或稍高信号。增强扫描7例呈明显均匀强化,1例呈明显脑回样强化,1例中等度强化,1例(放疗后)无强化。2例有侧脑室室管膜线样明显强化。9例存在占位效应。3例瘤周重度水肿,5例瘤周中度水肿,2例瘤周轻度水肿。结论:原发性中枢神经系统淋巴瘤是一种较为罕见的原发性中枢神经系统恶性肿瘤,MRI是诊断该病的重要的无创性检查方法。当男性中老年患者发现颅内,特别是幕上深部脑白质及胼胝体、基底节区实性占位性病变,呈稍长或等T1、稍长或等T2信号,瘤周水肿及占位效应较轻,增强扫描呈明显均匀强化时,应考虑原发性中枢神经系统淋巴瘤的诊断。
To describe the MR manifestations of primary central nervous system lymphoma and to discuss MR diagnostic value in this disease. Materials and Methods： MR imaging features of 10 patients with pathologically proved PCNSL were retrospectively analyzed. Results： All 10 cases were diffuse large B - cell non - Hodgkin＇s lymphomas. 5 patients had a single mass, while the other 5 had multiple lesions, with a total of 16 lesions. 8 lesions were located in the cerebral hemispheres, 4 in the basal ganglia, 1 in the right dorsal thalamus and basal ganglia, and 3 in the ventricles. All cases presented localized mass, 6 were with well - defined and 4 with ill - defined margins. The lesions showed slightly hypointense to isointense signal on T1WI and iso- to slightly hyperintense signal on T2WI. After Gd - DTPA adminis- tration, marked homogenous enhancement were seen in 7 cases, gyrus - like enhancement in 1 case and moderate enhancement in other one. One patient after radiotherapy showed no enhancement. 2 cases showed ependymal enhancement in the lateral ventricle. All but one had mass effect, and all had edema （3 strongly, 5 moderately, and 2 slightly edema）. Conclusion： PCNSL is a rare malignant primary cen- tral nervous system tumor and MRI is an important non - invasive diagnostic method for this disease. The diagnosis of PCNSL should be considered when a mid - aged or old man is found to have an intracranial solid lesion, especially in supratentorial deep white matter, corpus callosum or basal ganglia, which shows slightly hypointense to isointense on T1 WI and iso - to slightly hyperintense on T2 WI, with slight edema and mass effect, and marked homogenous enhancement.
出处
《中国医学计算机成像杂志》
CSCD
2006年第2期73-76,共4页
Chinese Computed Medical Imaging
