原发性颅内淋巴瘤的MRI诊断及鉴别诊断

目的探讨原发性颅内淋巴瘤的MRI表现和影像特征,以提高诊断和鉴别诊断水平。方法回顾性分析10例经手术病理证实的原发性颅内淋巴瘤MRI影像学表现。结果单发病灶9例,1例为多发病灶,肿瘤常位于脑深部或邻近脑膜,额叶2例,胼胝体2例,脑膜邻近2例,枕叶1例,中线区1例,幕下1例,多发1例。MRI平扫Tl WI呈稍低或等信号,T2WI呈等或稍高信号。肿瘤占位效应轻,多数轻中度水肿,一例为重度水肿。7例见典型的脐凹征、棘征、分叶征、握拳征、半月征、开环征等。结论原发性颅内淋巴瘤的影像学表现有一定的特征性,MRI在其定位和定性诊断中具有非常重要的价值。

MRI Diagnosis and Differential Diagnosis of Primary Intracranial Malignant Lymphoma

Objective To study MRI manifestations and characteristics of the primary intracranial lymphoma, in order to improve the level of diagnosis and differential diagnosis.Methods A retrospective analysis of MRI was performed in 10 patients with pathologically proven primary intracranial lymphoma.Results 9 cases were solitary lesions, the other case was multiple lesions, among these cases, tumors were often located in deep brain or the adjacent meninges. In detail, the tumor localization of these cases included the frontal lobe (n=2), corpus callosum (n=2), meningeal near (n=2), occipital lobe (n=1), central district (n=1), infratentorial brain (n=1), multiple (n=1). MRI scan was slightly low or equal signal on T1WI, T2WI was equal or higher signal. The mass effect of tumor was lightly, most cases were mild to moderate edema, only one was severe edema. In this study, 7 cases were characterized by typical umbilicus sign, spike sign, lobular sign, fist sign, open-loop sign.Conclusion There were certain characteristics about imaging manifestations of primary intracranial malignant lymphoma, and MRI plays a significant role in its localized and qualitative diagnosis.