摘要
目的探讨磁共振多模态成像在后颅窝原发性中枢神经系统淋巴瘤(PCNSL)中的诊断价值。方法回顾性分析经病理证实的16例后颅窝PCNSL患者的MR平扫、扩散加权成像(DWI)、动态增强及氢质子磁共振波谱(~1H-MRS)影像资料。结果 16例患者共有26个病灶,6例为多发病灶。所有病灶在T_1WI呈低或稍低信号;T_2WI上21个病灶呈稍高信号,3个呈等信号,2个呈混杂稍高信号;DWI上2例扩散受限呈高信号,13例扩散稍受限呈稍高信号,1例扩散不受限呈等信号。表观扩散系数(ADC)图上测得肿瘤实质与对照侧平均ADC值分别为(0.610±0.092)×10^(-3)mm^2/s和(0.700±0.044)×10^(-3)mm^2/s,两者差异有统计学意义(P=0.02,<0.05,Z=-2.269),r ADC为0.884±0.125。增强扫描26个病灶呈明显强化,其中12个病灶可见"尖角征"、"脐凹征",时间-信号强度(TIC)曲线为Ⅰ型(缓升型)。瘤周轻、中度水肿12例。MRS表现为病灶实质区出现高大的Lip峰。结论多模态磁共振成像有助于后颅窝PCNSL的明确诊断。
Objective To investigate the value of Multimodality imaging in primary central nervous system lymphoma of the posterior fossa. Methods Routine magnetic resonance imaging（ MRI）,DWI,dynamic contrast-enhanced MRI and ^1H-MRS features of 16 patients with pathologically documented lymphomas were retrospectively collected and analyzed.Results Six patients（ 37. 5%） had multifocal lesions,which added up to a total of 26 lesions. The MRI showed that all lesions（ n = 26） appeared to be hypointense on T1 WI,and the lesions displayed mild hyperintensity（ n = 21）,isointensity（ n = 3） and mixed mild hyperintensity（ n = 2） on T2 WI. On DWI,most lesions showed homogeneously slightly hyperintense appearances（ n = 13）,and the mean ADC value of tumor was lower than the control region（ respectively,（ 0. 610 ±0. 092） × 10～（- 3）mm～2/ s,（ 0. 700 ± 0. 044） × 10～（- 3）mm～2/ s）,and the difference was statistically significant（ P = 0. 02 0. 05,Z =- 2. 269）. The tumors＇ ADC ratios were 0. 884 ± 0. 125. All of the lesions（ n = 26） showed obvious enhancement,12 of these 26 lesions presented the‘cusp sign＇and‘notch sign＇. The TIC curve was anⅠpattern. 75%（ 12 /16）had moderate or mild edema. The MRS of lymphomas revealed an increased lipid（ Lip） peak. Conclusion Multimodality imaging is more conducive to obtain a clear diagnosis of primary central nervous system lymphoma in the posterior fossa.
出处
《临床放射学杂志》
CSCD
北大核心
2016年第9期1303-1307,共5页
Journal of Clinical Radiology
关键词
后颅窝
原发性中枢神经系统淋巴瘤
多模态成像
Posterior fossa
Primary central nervous system lymphoma
Multimodality imaging
