中枢神经系统白血病的CT及MRI主要表现

目的 分析经临床证实的11例中枢神经系统白血病的CT及MRI表现,探讨其影像学特征,增进对该病的认识,为临床诊断提供依据.方法 回顾性分析经临床证实的11例中枢神经系统白血病CT及MRI的影像学表现.其中4例CT平扫后行MRI平扫及增强扫描检查;其余7例直接行MRI平扫或平扫+增强扫描检查.结果 ①白血病浸润软脑膜5例,CT表现为脑沟、脑池消失,内可见条状低密度灶,对应MRI表现为T1WI呈低信号,T2WI/FLAIR呈高信号,脑回肿胀,DWI呈稍高信号,增强后明显强化;合并蛛网膜下腔出血1例.②脑实质浸润6例,单发肿块2例,余均为多发,MRI表现T1WI低信号,T2WI/FLAIR高信号,DWI高信号,无明显占位效应,增强后明显强化;其中3例合并出血.③硬脑膜受累1例,累及额部板障,CT表现为软组织密度灶,MRI表现为软组织信号灶,增强后明显强化.结论 中枢神经系统白血病影像学表现有一定的特征性,影像学检查尤其是MRI增强检查有助于对中枢神经系统白血病表现的认识,以及诊断及鉴别诊断.

The CT and MRI diagnosis of central nervous system leukemia

Objective To improve and retrospectively analyze the level of the diagnosis, the CT and MRI findings of 11 cases who were clinically confirmed of the central nervous system leukemia.Methods We retrospectively analysed CT and MRI imaging findings of 11 cases about the central nervous system leukemia, who were confirmed by clinical methods. 4 patients were performed with CT by scan followed by a MRI scan and enhanced by scan; the rest of the 7 patients were examined with MRI scan line directly or plain scan plus enhancement.Results ①Leukemic infiltration pia mater was found in 5 cases, CT showed that brain ditch, brain pool disappeared, strip can be seen in the low density foci, corresponding MRI performance for T1WI low signal, T2WI/FLAIR showed high signal, brain swelling, slightly higher DWI was found, with obvious enhancement after enhancing; Combined subarachnoid hemorrhage in 1 case;②Parenchyma was invaded in 6 cases with 2 cases of a single mass. Other cases were multiple, MRI was showed by T1WI low signal, T2WI/FLAIR high signal, DWI high signal, without obvious placeholder effect, obvious enhancement after enhancing;3 cases with bleeding;③Paritetal bone was involved in 1 case, CT manifestated the oval soft tissue density, MRI was characterized by oval tissue signal oven,obvious enhancement after enhancing.Conclusion The imaging of leukemia of the central nervous system has its own characteristics. MRI, especially enhanced MRI, is a useful tool for the diagnosis of the leukemia of the central nervous system.