摘要
目的 探讨原发性中枢神经系统淋巴瘤(PCNSL)的多模态磁共振成像(MRI)诊断价值.方法 回顾性分析2016年1月至2018年12月川北医学院附属医院收治的16例经病理学检查证实的PCNSL患者的多模态MRI表现.患者均行常规MRI平扫和增强扫描、弥散加权成像(DWI)、磁共振波谱(MRS)检查.结果 16例患者均为弥漫性大B细胞型非霍奇金淋巴瘤,单发7例,多发9例;共检出36个病灶,幕上30个,幕下6个.病灶位于脑室旁深部白质16个(其中2个病灶累及胼胝体),大脑半球浅部5个,基底节区7个,丘脑2个,小脑3个,脑干3个.T1WI呈等或稍低信号,T2WI均呈等或稍高信号.病灶周围均有不同程度水肿,轻至中度32个,重度4个.增强扫描31个病灶呈斑片状、结节状或团块状均匀强化,5个病灶表现不规则环形强化;12个病灶可见"缺口征",7个病灶可见"尖角征";病灶邻近脑膜或室管膜明显强化各1例.DWI示病灶实质部分高信号29个,等至稍高信号7个,表观弥散系数(ADC)值均降低.MRS示病灶实质区胆碱峰升高,N-乙酰天门冬氨酸(NAA)和肌酸峰降低,8例可见高耸脂质峰,3例出现倒置的乳酸双峰,2例同时存在脂质峰和乳酸双峰.结论 多模态MRI可以从不同方面反映PCNSL的特征,有助于提高PCNSL诊断的准确率.
Objective To investigate the diagnostic value of multimodal magnetic resonance imaging (MRI) in primary central nervous system lymphoma (PCNSL). Methods The multimodal MRI findings of 16 patients with PCNSL confirmed by histopathology from January 2016 to December 2018 in Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed. Routine MRI plain scan, enhancement, diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) examination were performed in all cases. Results All 16 patients were diagnosed with diffuse large B cell non-Hodgkin lymphoma. There were 7 cases with solitary lesions and 9 cases with multiple lesions. A total of 36 lesions were detected, with 30 above and 6 below the curtain. Sixteen lesions were located in the deep white matter near the ventricle (among which 2 lesions involved the corpus callosum), 5 lesions in the superficial cerebral hemisphere, 7 lesions in basal ganglia, 2 lesions in thalamus, 3 lesions in cerebellum, and 3 lesions were in brainstem. T1WI showed equal or slightly low signal, and T2WI showed equal or slightly high signal. There was different degree of edema around the lesions. 32 lesions were mild to moderate, and 4 lesions were severe. On enhancement scanning, 31 lesions showed patchy, nodular or lumpy uniform enhancement;5 lesions showed irregular annular enhancement. "Incision" was found in 12 lesions, and "angular" was found in 7 lesions. Obvious enhancement of adjacent meninges or ependymal membranes occurred in 1 case each. DWI showed 29 high signals in the focal areas and 7 equal or slightly high signals, and all apparent dispersion coefficient (ADC) values were reduced. MRS showed that choline peak increased, and N-acetyl aspartate (NAA) peak and creatine peak decreased in all cases. highly elevated lipid peak was observed in 8 cases, inverted lactic acid peak in 3 cases, and both lipid peak and lactic acid peak were observed in 2 cases. Conclusions Multimodal MRI can reflect the characteristics of PCNSL from different a
作者
张玉琴
邓艳
何茂远
姚前竞
翟昭华
Zhang Yuqin;Deng Yan;He Maoyuan;Yao Qianjing;Zhai Zhaohua(Department of Radiology,Affiliated Hospital of North Sichuan Medical College,Sichuan Nanchong 637000,China)
出处
《中国医师进修杂志》
2019年第11期1013-1016,共4页
Chinese Journal of Postgraduates of Medicine
关键词
淋巴瘤
中枢神经系统肿瘤
磁共振成像
回顾性研究
Lymphoma
Central nervous system neoplasms
Magnetic resonance imaging
Retrospective studies
