颅内原发性恶性淋巴瘤的CT和MRI诊断

目的:探讨颅内原发性恶性淋巴瘤的CT、MRI表现及其临床诊断价值。方法:对29例经手术和病理证实的颅内恶性淋巴瘤患者的CT、MRI检查资料进行回顾性分析。结果:CT平扫肿瘤呈边缘相对锐利的等、高密度灶;MR扫描T1WI呈等或稍低信号灶,T2WI呈等或稍高信号灶;增强扫描肿瘤常见均匀强化,呈“握拳样”或“团块样”;肿瘤常常位于脑表面或近中线部位;多数肿瘤轻至中度水肿,占位效应轻。结论:颅内原发性恶性淋巴瘤的影像学表现与某些神经系统病变有类似和重叠之处,但通过认真地分析影像表现并结合活检结果,CT、MR扫描有利于该病变的诊断与鉴别诊断,并减少误诊。

CT and MRI Diagnosis of Primary Malignant Lymphomas in the Brain

Objective:To investigate the role of CT and MRI in diagnosis of primary malignant lymphomas in the brain.Methods:Twenty nine cases of primary malignant lymphomas in the brain proved by operation and pathology were examined by CT and MRI before operation.CT and MRI features were analysed retrospectively.Results:On CT scan appearances,most lesions were isodensity or hyperdensity.The MRI appearances were as following:on T_1WI,the lesions were isointense or slightly hypointense while isointense or hyperintense on T_2WI.Homogeneous enhancement presented in most of the tumors,like "closed fist" or "clump",most lesions were located near the surface or middle line of cerebrum.Most tumors in the brain showed minimal or moderate edema and space occupation effect.Conclusion:The CT and MRI findings of the primary malignant lymphomas overlap with those of other intracranial mass lesions.Through careful analysis of the CT and MRI appearances and integrating with the needle biopsy,CT and MRI are helpful in diagnosis and differential diagnosis of primary malignant lymphomas in the brain and reduce misdiagnosis.