原发性脑内淋巴瘤的磁共振成像表现

目的：探讨原发性脑内淋巴瘤的磁共振成像(magnetic resonance imaging，MRI)特征，提高对该病的诊断及 鉴别诊断能力。方法：回顾性分析经术后病理确诊的14例原发性脑内淋巴瘤的临床资料及MRI表现。结果：14例患 者中男5例，女9例，年龄(55±8)岁；9例为单发，5例多发(病灶2~6个)，共26个病灶。病灶均位于幕上，包括大脑半 球、基底节、胼胝体等，多数位于脑组织深部。病灶T1加权成像(T1-weighted image，T1WI)多呈等或稍低信号，T2加 权成像(T2-weighted image，T2WI)多呈等或稍高信号，弥散加权成像(disff usion-weighted imaging，DWI)多呈高或稍高信 号。全部病灶表现出明显的强化影，其中团块状强化的病灶有23个，环形强化的病灶有3个。病灶周围形成的水肿严 重程度不一，其中20个属于重度，4个中度，2个轻度。有2个病灶可见坏死、出血。结论：原发性脑内淋巴瘤具有特 征性MRI表现：位于幕上脑实质深部，多灶生长，信号强度与脑灰质接近，强化明显，弥散受限，坏死囊变少见， 占位效应明显。

Magnetic resonance imaging features for primary brain lymphoma

Objective: To investigate the magnetic resonance imaging (MRI) features for primary brain lymphoma and improve its diagnosis and diff erential diagnosis. Methods: The clinical and MRI data from 14 patients with primary brain lymphoma were retrospectively reviewed. Results: Fourteen patients, including 5 males and 9 females, were (55±8) years old. Th ere were 9 patients with single lesion and 5 patients with multiple lesions (2–6 lesions). A total of 26 lesions were identifi ed. All lesions located in supratentorium, such as the cerebral hemisphere, the basal ganglia, and the corpus callosum. Most of them deeply located in the brain. Th e lesions presented slightly low or equal signal on T1-weighted image (T1WI), slightly high or equal signal on T2- weighted image (T2WI), and slightly high or equal signal on disff usion-weighted imaging (DWI), in which 2 lesions showed central necrosis and 2 lesions included hemorrhage. All of them showed significant enhancement, 3 of them showed annular enhancement, and the rest showed nodular and mass enhancement. The degree of para-tumorous edema for different lesions was different, including 20 lesions with marked edema, 4 with moderate edema, and 2 with slight edema. Conclusion: MRI features for primary brain lymphoma are specific. The tumors mostly locate in supratentorium and deep brain, showing multifocal growth, isointense to grey matter at T1WI and T2WI, marked enhancement, restricted diffusionon DWI, rare necrosis, and obvious space occupying effect.