MRI对原发性中枢神经系统淋巴瘤的诊断价值探讨

目的探讨磁共振成像(MRI)对原发性中枢神经系统淋巴瘤(PCNSL)的诊断价值。方法 50例疑似原发性中枢神经系统淋巴瘤患者,随机分为对照组与研究组,各25例。对照组患者接受CT检查,研究组患者接受MRI检查。分析所有患者的手术病理结果;对比两组患者对病灶的检测准确率。结果 50例患者均接受手术病理确诊,对照组患者中有64个病灶,边界清晰的38个,边界较为清晰的19个,边界模糊不清的7个;所有病灶均未出现出血以及钙化,仅有18个病灶周围未见水肿;研究组患者中有73个病灶,边界清晰的43个,边界较为清晰的21个,边界模糊不清的9个;所有病灶均未出现出血以及钙化,仅有20个病灶周围未见水肿。研究组患者的病灶、边界清晰、边界较为清晰、病灶周围未见水肿的检测准确率分别为95.89%、95.35%、95.24%、95.00%,均高于对照组的73.44%、78.95%、63.16%、55.56%,差异有统计学意义(P<0.05);研究组边界模糊不清的检测准确率为100.00%,与对照组的71.43%比较,差异无统计学意义(P>0.05)。结论原发性中枢神经系统淋巴瘤采用进行MRI诊断,结合患者的个体情况,可对于确诊原发性中枢神经系统淋巴瘤有一定的提示作用,同时MRI还能探查到患者的病灶具体情况,为患者临床治疗方案提供参考依据,该诊断方式值得推广。

Discussion on diagnostic value of MRI in primary central nervous system lymphoma

Objective To discuss the clinical value of magnetic resonance imaging(MRI) in diagnosis of primary central nervous system lymphoma(PCNSL). Methods A total of 50 cases of suspected primary central nervous system lymphoma were randomly divided into control group and research group, with 25 cases in each group. The control group received CT examination, and the research group received MRI examination. The surgical and pathological results of all patients were analyzed, and the accuracy rate of lesions detection between the two groups was compared. Results All 50 patients were diagnosed by surgery and pathology. There were 64 lesions in the control group, of which 38 lesions with very clear boundary, 19 lesions with clear boundary, and 7 lesions with ambiguous boundary. No bleeding or calcification was found in all lesions, only 18 lesions with no edema around. There were 73 lesions in the control group, of which 43 lesions with very clear boundary, 21 lesions with clear boundary, and 9 lesions with ambiguous boundary. No bleeding or calcification was found in all lesions, only 20 lesions with no edema around. The detection accuracy of lesions, very clear border, clear border and lesions with no edema around in the research group were 95.89%, 95.35%, 95.24% and 95.00% respectively, which were higher than 73.44%, 78.95%, 63.16% and 55.56%, respectively in the control group, and the difference was statistically significant(P<0.05). The detection accuracy of the ambiguous boundary of the research group was 100.00%, which had no statistically significant difference compared with 71.43% in the control group(P>0.05). Conclusion The application of MRI in diagnosis of primary central nervous system lymphoma, combined with the individual situation of the patient, can give some hints for the diagnosis of primary central nervous system lymphoma. At the same time, MRI can detect the specific situation of the patient’s lesions and provide reference for the clinical treatment plan of the patient. This diagnosis method is worth popularizing.