原发性中枢神经系统弥漫性大B细胞淋巴瘤的多模态影像学特征分析

目的 探讨原发性中枢神经系统弥漫性大B细胞淋巴瘤(PCNS-DLBCL)的影像学特征.方法 回顾性分析经病理证实的23例PCNS-DLBCL患者的临床及影像学资料.结果 13例患者为单发病灶,10例患者为多发病灶.病灶主要分布于胼胝体及侧脑室周围的脑深部,瘤周水肿多为轻中度;部分患者有轻中度占位效应.CT检查示病灶多为...

Multi-modality imaging features analysis of primary central nervous system diffuse large B-cell lymphoma

Objective To investigate the multi-modality imaging features of primary central nervous system diffuse large B-cell lymphoma(PCNS-DLBCL).Methods The clinical imaging data of 23 patients with PCNS-DLBCL confirmed by pathology were analyzed retrospectively.Results 13 cases were solitary,10 were multiple,mainly distributed in the brain around the corpus callosum and lateral ventricles.The peritumoral edema was mostly mild to moderate,and some cases showed mild to moderate space occupying effect.The lesions were mostly of equal/slightly high density on CT and equal/slightly long T1WI,equal/slightly long T2WI signal,FLAIR presented equal/slightly high signal on MRI.DWI showed hyperintense.Most of the lesions showed massive and nodular enhancement on contrast-enhanced scan.On contrast-enhanced MRI scan,the characteristics of“clench fist sign”,“sharp angle sign”,“fissure sign”,“butterfly sign”,“satellite focus”and“hard ring sign”can be seen.The 1H-MRS showed that Cho peak increased,NAA peak decreased,Cr peak decreased slightly,high Lip peak and inverted Lac peak,and the tumor parenchyma area on PWI was hypoperfusion.18F-FDG-PET examination showed that the lesions were obviously high metabolism.The multiple cases are mostly confined to the supratentorial and have regional distribution characteristics.The density,signal and enhancement manifestations were more diverse than those of single cases.The incidence of“clench fist sign”,“fissure sign”,and“butterfly sign”on contrast-enhanced MRI scan in solifary cases was higher than that in multiple cases.Conclusion The multi-modality imaging manifestations of PCNS-DLBCL have certain characteristics,which is helpful for its early and accurate diagnosis.