摘要
目的:探讨常规MRI扫描通过结合DWI、PWI、TDC、MRS多项技术联合应用对原发性脑内恶性淋巴瘤的诊断价值。方法:回顾性分析29例经临床病理证实的原发性脑内恶性淋巴瘤病例,其治疗前常规MRI信号特点与DWI、PWI、TDC和MRS的表现。结果:原发性脑内恶性淋巴瘤T_1WI呈等或稍低信号,T_2WI呈稍高信号,灶周中度水肿,增强后大多呈均匀强化,顶叶病灶可见"压迹征",病变累及胼胝体时呈"蝴蝶征";DWI多呈均匀高信号,ADC值与对侧正常脑实质相比明显降低;PWI示rCBV呈等或等低灌注,与正常脑白质灌注相似,多呈黄绿或蓝色;TDC负性增强上升支与下降支基本对称,信号强度回复前出现一小的再下降波形,增强后基线水平较增强前基线水平呈缓慢上升;MRS示Cho峰明显升高,病灶内NAA中度、Cr峰轻度降低,可见Lip峰、Cho/Cr、Lip/Cr、Lac/Cr均明显升高,NAA/Cr明显降低。结论:原发性脑内恶性淋巴瘤常规MRI具有一定特征性,通过联合应用DWI、ADC、PWI、TDC和MRS表现可提高对其诊断水平。
Purpose： To evaluate the value of the combination of multi-technique MRI such as DWI, PWI, TDC, MRS in diagnosis of primary brain lymphoma. Materials： Twenty-nine cases of primary brain lym- phoma confirmed by clinical and pathological results were enrolled in our study. The signal characteristics of the tumors in conventional MRI, DWI, PWI and MRS which were done before and after treatment were retrospectively analyzed. Results： Primary malignant lymphomas of the brain were shown with equal or slightly lower signal intensity on T1WI, slightly higher signal intensity on T2WI. The perifocal edemas were moderate.Most tumors wre shown with homogeneous enhancement after contrasted. The parietal lesions can be shown with ＂indentation＂ sign. When the lesion involved the corpus callosum, a ＂butterfly＂ sign could be shown. The tumors were mostly homogeneous high intensity signal on DWI, the ADC values of them were much lower than that of the contralateral normal brain parenchyma. PWI showed the tumors were with low rCBV, nearly the same as the normal white matter. The TDC negative ascending branch and descending branch were basically symmetrical. MRS showed the tumors were with significantly higher Cho peak, moder- ate MAA peak, slightly lower Cr peak, and visible Lip peak. The ratios of Cho / Cr, Lip / Cr, Lac / Cr were significantly increased, the ratios of NAA / Cr was significantly reduced. Conclusion： Conventional MRI of primary malignant lymphoma of the brain has a certain characteristic, through the combination of DWI, PWI, TDC and MRS the performance of their diagnosis can be improved.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2012年第4期289-293,共5页
Chinese Computed Medical Imaging
