摘要
目的探讨原发性中枢神经系统淋巴瘤(PCNSL)多模态MRI与病理学基础,以提高对该病诊断的准确性。方法回顾性分析15例经病理证实为PCNSL的MRI特征与病理资料进行对照分析。结果 15例均为非霍奇金淋巴瘤,B细胞性14例,T细胞性1例。单发9例,多发6例;共检出24个病灶。病灶好发于幕上(22个),主要分布于深部脑白质等近中线部位,幕下少见。MRI平扫病灶T1WI多呈等或稍低信号,T2WI及液体衰减反转恢复序列(FLAIR)多呈等或稍高信号。瘤周水肿轻度9个,中度7个,重度6个,位于侧脑室和脑膜各1个病灶周围无水肿。增强扫描24个病灶实质成分均呈团块状、结节状或环形均匀明显强化,其中4个病灶囊变坏死区无强化,10个病灶出现"缺口征",7个病灶出现"尖角征",3个病灶累及胼胝体出现"蝶翼征",具有特征性。15例行扩散加权成像(DWI)多呈高或稍高信号。8例行氢质子磁共振波谱(1H-MRS)表现为病灶实质区N-乙酰天门冬氨酸(NAA)峰中度降低、肌酸(Cr)峰轻度降低,胆碱(Cho)峰显著升高,并可见高耸的脂质(Lip)峰,具有特征性。结论 PCNSL的病理学基础决定其MRI表现有一定特征性,结合DWI、MRS等多模态功能成像手段,有助于提高该病诊断准确性和鉴别诊断能力。
Objective To explore the pathological manifestations and multimodal MRI features of primary central nervous system lymphoma（PCNSL）, in order to improve the accuracy of diagnosis of the disease. Methods 15 cases of PCNSL proved by pathology were collected in the study analyzed retrospectively, including MRI manifestations and pathological data. Results 15 cases were non-Hodgkin＇s lymphoma, 14 cases of B-cell and I cases of T-cell. Nine cases had single lesion and six cases had multiple lesion. Total 24 lesions were tbund. Lesions occur in the supratentorial region （22）, mainly located in the deep white matter near the midline infratentorial. Lesion occur in the infratentorial is rare. The lesions showed hypointensity or slightly isointensity signal on T1W1, hypointensity or slightly hyperintensity signal on T2WI and FLAIR. 9 lesions in mild edema, 7 lesions in moderate edema, 6 lesions in severe edema. The lesion is no edema around located in lateral ventricles and meninges, 24 lesions of contrast enhancement were intensive homogenous such as clumping, nodosity and ringlike. 4 lesions were seen cystic necrosis no enhancement, the presence of ＂incision sign＂ in 10 lesions, ＂angular sign＂ in 7 lesions, and ＂butterfly sign＂ in 3 lesions were more specific. The lesions of 15 cases showed slightly hyperintensity or hyperintensity signal on diffusion-weighted imag- ing （DWI）. 8 cases underwent proton magnetic resonance spectroscopy （~H-MRS） showed moderate decreased N-acetyl aspartate （NAA） peak, slightly lower peak creatine （Crj, significantly increased choline （Cho） peak and highly elevated lipid （Lip） peak. Conclu- sion The pathology of PCNSL determined the MRI features, combined with multinlodal means of the functional imaging of DW1 and ~H-MRS, might help to improve the accu- racy of diagnosis and differential diagnosis.
出处
《中国CT和MRI杂志》
2012年第6期8-11,84,共5页
Chinese Journal of CT and MRI
关键词
中枢神经系统
淋巴瘤
磁共振成像
多模态
病理学
Central nervous system
Lymphoma
Magnetic resonance imaging,Multimodality
Pathology
