原发性脑内恶性淋巴瘤的MRI诊断

目的:探讨脑内原发性恶性淋巴瘤的MRI表现特征,以提高其诊断的正确率。方法:回顾分析10例经病理证实的脑内原发性恶性淋巴瘤MRI表现。结果:10例中单发病灶2例,多发病灶8例,共检出病灶35个,分别位于额叶、顶叶、胼胝体、基底节、小脑半球、小脑蚓。病灶可有不同程度水肿及占位效应,MRI平扫T1WI多呈稍低信号,T2WI呈等或稍高信号,FLAIR呈稍高或高信号,DWI多为稍高或高信号,亦可为等信号。增强扫描病灶多为明显均匀或欠均匀结节、团块样强化,少数为环形强化,可有“缺口征”、“尖角征”。结论:脑内原发性恶性淋巴瘤MRI表现有一定特征,认真分析其影像表现,可提高其诊断准确性。

MRI in diagnosis of primary intracerebral malignant lymphoma

Objective: To investigate MRI features of primary intracerebral malignant lymphoma (PICML). Methods: MRI findings in 10 patients with pathologically-proved PICML were retrospectively analyzed. Results: 35 lesions were identified in 10 patients, single lesion was seen in 2 and multiple lesions in 8, 13 lesions located in the deep white matter, 2 in the callus corpus, 10 in the cerebellum, 1 in the brain stem and 6 in the surface. The lesions presented as node or mass in shape with slight preitumorous edema and mass effect. On plain MRI scans, all lesions presented as iso-or slight hypointense on T\-1WI, while all lesions presented as iso-or slight hyperintense on T\-2WI and slight hyperintense or hyperintense on FLAIR, most of the lesions presented as slight hyperintense or hyperintense on DWI. Obvious homogenous mass-like or nodular enhancement were seen on Gd-DTPA –enhanced MRI, 4 presented as “incision sign” and “angular sign”. Conclusion: Primary intracerebral malignant lymphoma has features on MRI images, correct diagnosis can be made in most cases when imaging findings are combined with clinical information.