免疫状态正常人原发性中枢神经系统恶性淋巴瘤的CT、MRI特征(附26例报告)

目的:探讨CT和MRI对免疫状态正常人原发性中枢神经系统恶性淋巴瘤的诊断价值。方法:对26例经手术和病理证实的脑内淋巴瘤的CT和MRI影像学表现进行回顾性分析。结果:26例患者共发现病灶39个,病灶除分布于额叶、颞叶、基底节等常见部位外,还可见于胼胝体、视交叉和松果体区。CT平扫:95%的病灶呈等或高密度,82%呈均匀密度。MRI:T1WI呈等或稍低信号病灶占90%,T2WI呈等或稍高信号病灶占100%。多数瘤灶呈轻至中度周围水肿(82%)和占位效应(82%)。CT和MRI增强扫描多为均匀强化。结论:脑内原发淋巴瘤少见,影像学表现与颅内其它肿瘤互相重叠,CT和MRI平扫和增强扫描的应用有助于脑内淋巴瘤的诊断和鉴别诊断。

Primary Malignant Central Nervous System Lymphoma in Immunocompetent Individuals:CT and MR Features (a Study of 26 Cases)

Objective:To investigate the role of CT and MRI in the diagnosis of primary malignant central nervous system lymphoma in immunocompetent individuals.Methods:CT and MRI features of 26 cases of patients with intracranial lymphoma were retrospectively studied.Results:39 lesions were found in the 26 cases.Other than its prevailing locations (basal ganglia,temporal and frontal lobes) of intracranial lymphoma,a few lymphoma lesions were also detected in the sites of corpus callosum,optic chiasma and pineal body.On CT,95 of lesions appeared as identical or high density related to brain parenchyma and 82 were homogeneous.On T_1WI,90 of lesions were isointense or slightly hypointense,while 100 were isointense or slightly hyperintense on T_2WI.Most of the lymphoma in the brain showed mild or moderate perifocal edema (82) and mass effect (82).Homogeneous enhancement presented in most of the tumors.Conclusion:Primary brain lymphoma was a rare tumor with imaging findings overlapping with those of the other intracranial mass lesions.The application of plain and enhanced CT and MRI scanning was helpful in the diagnosis and differential diagnosis of intracranial lymphoma.