原发性脑淋巴瘤的MRI影像表现与诊断

目的探讨原发性脑淋巴瘤（PLB）的MRI影像表现,以提高对该病的诊断率。方法回顾分析经手术病理及临床治疗证实的12例PLB患者（观察组）的临床资料,另外选择在我院就诊的20例颅内转移瘤患者作为对照组。结果 12例PLB患者中单发病灶者8例,多发病灶者4例,共计18个病灶,其中位于基底节区5个、大脑半球10个和小脑3个。观察组肿瘤病灶累及深部脑组织患者8例,明显高于对照组的2例（P〈0.05）;观察组多发病灶呈区域性分布的比例明显高于对照组（P〈0.05）;观察组在低信号、等或稍高信号、高信号方面与对照组差异有统计学意义（P〈0.05）;观察组患者中具有明显囊变、坏死特征性改变1例,明显低于对照组的14例（P〈0.05）;观察组患者有9例肿瘤组织在MRI增强扫描中有局部刺状突起,明显高于对照组的1例（P〈0.05）。结论脑原发性淋巴瘤的MRI表现具有一定的特征性,在与其他颅内肿瘤鉴别中具有一定的诊断价值。

MRI appearance and diagnosis of primary lymphoma of the brain.

Objective To investigate the MRI appearance of primary lymphoma of the brain （PLB）, in order to improve the diagnosis rate. Methods The clinical data of 12 patients with PLB （the study group） were retrospec- tively analyzed, and 20 patients with brain metastases were selected as the control group. Results Of the 12 cases, 8 were single lesion, 4 were multiple lesions, with a total of 18 lesions, of which 5 were located in basal ganglia, 10 in cerebral hemispheres and 3 in cerebellum. Eight patients in the study group were with tumor lesions involving the deep brain tissue, significantly more than 2 patients in the control group （P〈0.05）. The proportion of multiple lesions showed that the regional distribution in the study group was significantly higher than the control group （P〈0.05）. The two groups showed statistically significant difference in Low signal, equal or slightly higher signal, high signal （P〈 0.05）. One patient in the study group were with obvious cystic change and necrosis, significantly less than 14 patients in the control group of （P〈0.05）. Nine patients in the study group were found with partial them-like protuberances in MRI, significantly more than one patient in the contTol group P〈0.05）. Conclusion The MRI appearance of primary cerebral lymphoma has certain characteristics, which provides certain diagnostic value in differentiating from other in- tracranial tumors.