颅内原发性恶性淋巴瘤影像学诊断和鉴别诊断

目的探讨颅内原发性恶性淋巴瘤CT和MR影像学表现特点，提高本病的影像诊断水平。方法收集经手术、病理和免疫组化证实，资料齐全的颅内恶性非霍奇金淋巴瘤22例，回顾性分析其临床、CT和MR表现。结果临床主要症状为头痛、恶心、偏瘫、肢体麻痹、视觉障碍等。肿瘤常常位于脑表面或近中线部位，CT扫描大多表现为等或稍高均匀密度肿块，T1WI呈略低或等信号，T2WI为低、等或略高信号，增强扫描病灶为明显均匀或不均匀强化，多呈“类圆形”或“团块状”。所有病灶都有占住效应，水肿程度不一。结论脑原发性恶性淋巴瘤影像表现多样，但具有一定特征，CT、MR扫描有助于该病变的诊断与鉴别诊断，为临床治疗方案提供重要依据。

Imaging diagnosis and differential diagnosis of primary intracranial malignant lymphoma

Objective To explore the appearances of CT and MR with primary intracranial malignant lymphoma, in order to heighten the level of image diagnostics. Methods The clinical manifestations and findings of CT and MR1 were analyzed retrospectively in 22 patients with primary intracranial malignant non - Hodgkin lymphonm proved by surgery, pathology and immunohistochemistry. Results The chief clinical manifestations were headache,nausea, hemiparesis, cerebellar signs, cranialnerve palsies, and visual disturbances. Most lesions were located near the surface or middle line of cerebrum. Most of the manifested isodensity or hyperdense masses on CT scan. And slightly hypointense or isointeme on T1WI, and sligtly hypointense or isointnse or slightly hyperinteme on T2WI,and homogeneous or inhomogeneous Gd- DTPA enhancement presentedin most of the tumors ,like＂round＂or＂elump＂. Mass effect and various edema surrounding the lesion can be seen in all the cases. Conclusions Primary intracranial malignant lymphoma has various imaging appearances, and there are the characteristic features. CT and MR are helpful in diagnosis and differential diagnosis,which can provide important information for therapeutic planning.