磁共振多技术联合应用对脑原发性淋巴瘤的诊断价值  

The role of MRI combined with other techniques in diagnosis of primary lymphoma of the brain

作　　者：郭炳伦[1] 黄文起[1] 李玉舟[1] 孙化[1] 

机构地区：[1]商丘市第一人民医院MRI室,河南省476100

出　　处：《中华临床医师杂志（电子版）》2012年第16期4655-4658,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨磁共振多技术联合应用对脑原发性淋巴瘤的诊断价值。方法收集2005～2011年经手术或穿刺检查病理证实的12例脑原发性淋巴瘤患者MRI表现,并进行回顾性分析。结果 12例中共发现病灶25个,多发8例,单发4例。MRI表现为脑内多发团块状等、低T1,等、高T2异常信号,弥散加权成像(DWI)呈高或略高信号,周围水肿较轻。其中20个病灶位于脑深部中线旁,5个病灶位于幕下。增强扫描21个病灶呈团块状强化,4个病灶呈不规则厚环状强化。其中8个病灶可见脑室周围增强征、6个镜像征,4个缺口征。6例行磁共振氢波谱(1H-MRS)检查,均表现为N-乙酰天门冬氨酸(NAA)、肌酸(Cr)峰降低,胆碱(CHO)峰升高,见乳酸(Lac)峰和高大脂肪(Lip)峰。结论磁共振是诊断脑原发性淋巴瘤的重要手段;脑室周围增强征、镜像征及缺口征是脑原发性淋巴瘤的特征性MRI表现;磁共振多技术的联合应用能提高脑原发性淋巴瘤的诊断与鉴别诊断水平。Objective To discuss the role of MRI combined with other techniques in diagnosis of primary lymphoma of the brain Methods MRI manifestation in 12 patients of primary lymphoma of the brain,confirmed by operation,pathology and laboratory examination from 2005 to 2011 were retrospectively analyzed.Results The 12 patients were found lymphoma with 25 focuses,4 of the patients had single focus and the others had multiple focus.the 20 focuses located in the median supratentorial peri-ventricular deep,the focuses displayed more round of mass.Focuses display equal or low T1,high T2 signal and DWI showed high or a slightly higher signal.The 5 focuses display mild edema around the lesion,contrast enhanced scanning showed that 21 focuses display strengthen lumps,4 focuses of irregular thick ring-like enhancement,8 focuses display visible mirror in film by peri-ventricular enhancement.6 showed'gap sign'.4 display visible mirror in film by peri-ventricular enhancement.6 cases underwent 1H-MRS examination performed for NAA,Cr peak reduction,CHO peak increases,see Lip Lac peaks and tall peaks.Conclusions MRI is an important way to diagnose of primary lymphoma of the brain,the brain ventricle acroteric intensive sign and the enhancement video image and mirror shadow in is characteristic performance of primary lymphoma in brain;MRI combined with more technology can improve the diagnosis and differential diagnosis level in the primary lymphoma of the brain.

关 键 词：脑 淋巴瘤 磁共振成像 弥散 磁共振波谱 

分 类 号：R739.4[医药卫生—肿瘤]