摘要
目的探讨原发性中枢神经系统淋巴瘤(PCNSL)与继发性中枢神经系统淋巴瘤(SCNSL)的磁共振成像(MRI)表现差异。方法回顾性分析21例PCNSL和8例SCNSL的MRI表现,比较病灶部位、数目、形态、信号、强化类型、瘤周水肿及占位效应。结果 PCNSL 21例(100%)病灶皆位于脑内,多发11例(52%);病灶数共51个,其中团块状22个(43%)、结节状20个(39%);大多数病灶呈稍低T1信号39个(76%)、稍高T2信号27个(53%);少数见囊变坏死9个(18%);病灶主要呈显著均匀强化45个(88%);瘤周水肿程度以轻度占多数20个(39%),其次为重度19个(37%);以轻度占位效应占多数24个(47%),其次为无占位效应20个(39%)。SCNSL病灶以柔脑膜播散6例(75%)为多数;多发6例(75%);病灶数共27个,等T1信号18个(67%)、等T2信号14个(52%);所有27个(100%)病灶呈显著均匀强化;大多数病灶23个(85%)无瘤周水肿及占位效应。结论 PCNSL与脑实质内SCNSL的MRI表现相似,常规MRI难以鉴别;与通过柔脑膜播散转移的SCNSL的MRI表现不同。
Objective To investigate the differences of MR imaging manifestations between primary and secondary CNS lymphoma.Methods To analyze MR imaging manifestations of 21 cases of PCNSL and 8 cases of SCNSL retrospectively,and compare the lesions location,number,shape,signal intensity,enhancement pattern,peritumor edema and mass effect.Results 21 cases（100%）PCNSL all located in the brain,11（52%）cases were multiplicity,the number of all lesions was 51,the shapes of them were mass（n=22）（43%） and nodular（n=20）（39%） mainly,most lesions were slight hypointense T1 signal intensity（n=39）（76%） and slight hyperintense T2 signal intensity（n=27）（53%）,a few（n=9）（18%）were cystic or necrotic,the lesions were markedly homogenous enhancement mainly（n=45）（88%）,peritumor edema was sight（n=20）（39%） mostly and secondly was massive（n=19）（37%）,most lesions were slight mass effect（n=24）（47%） and some were no mass effect secondly（n=20）（39%）.6 cases（75%）SCNSL were leptomeningeal spread and 6 cases（75%） were multiplicity,the number of all lesions was 27,most lesions were isointense T1 signal intensity（n=18）（67%） and isointense T2 signal intensity（n=14）（52%）,all（n=27）（100%）were markedly homogenous enhancement,most lesions（n=23）（85%） showed no peritumor edema and mass effect.Conclusion PCNSL and parenchymal lesions of SCNSL had similar MRI manifestations,which routine MRI was difficult to differeniate,and were different from SCNSL with leptomeningeal spread and metastases.
出处
《重庆医学》
CAS
CSCD
北大核心
2012年第35期3707-3709,3712,共4页
Chongqing medicine
关键词
淋巴瘤
中枢神经系统
磁共振成像
lymphoma
central nervous system
magnetic resonance imaging
