原发性脑内恶性淋巴瘤的MRI诊断及其临床意义

目的探讨原发性脑内恶性淋巴瘤的MRI特征。方法回顾性分析15例经病理证实的原发性脑内恶性淋巴瘤患者的MRI资料,并与病理资料进行对照分析。结果15例中12例单发,3例多发,共有18个病灶,其中位于顶叶的病灶6个,占33%;位于胼胝体3个,占17%;位于基底节3个,占17%;位于鞍区3个,占17%;位于小脑3个,占17%。原发性脑内恶性淋巴瘤的影像学形态多为类圆形肿块或结节,大部分瘤周水肿及占位效应较轻,个别较为明显。MRI平扫中,T1WI上12个病灶呈等信号或略低信号,其余6个呈低信号;在T2WI上9个病灶呈等信号,9个呈略高信号,增强扫描显示病灶呈团块状或结节状均匀明显强化,典型患者可见"握拳样"改变。结论原发性脑内恶性淋巴瘤的MRI表现具有一定的特征性,结合影像学及其他临床资料可做出正确诊断。

MRI Diagnosis of Primary Intracerbral Malignant Lymphoma and Its Clinical Significance

Objective To investigate MRI features of primary intracerebral malignant lymphoma(PICML).Methods MRI findings of 15 PICML patients confirmed pathologically were retrospectively analyzed and compared with pathologic results.Results Out of 15 cases,single lesion was seen in 12 and multiple lesions in 3.There were 18 lesions altogether,of which 6 were located in para-ventricular deep white matter(33%),3 in corpus callsum(17%),3 in basal ganglia(17%),3 in saddle area(17%),and 3 in cerebellum(17%).In imaging,most PICML appeared as multi-round lumps or nodules,around which most edema and space-occupying effect were slight.In plain scan of MRI,12 lesions presented as iso-or slight-hypo-signal and and the remaining 6 as hypo-signal in T1WI;nine lesions presented as iso-signal and 9 as slight-hyper-signal in T2WI.Enhanced scan showed that lesions took a mass shape or nodular uniform was obviously strengthened,and fist-making-like change was seen in typical patients.Conclusion PICML carries certain MRI features.More accurate diagnosis can be made when imaging findings is combined with clinical information.