脑内原发性恶性淋巴瘤的MRI诊断  

MRI diagnosis of primary malignant lymphomas in the brain

作　　者：章跃武[1] 朱希松[1] 余新春[1] 吴渭贤[1] 

机构地区：[1]浙江省衢州市人民医院,浙江衢州324000

出　　处：《中国临床医学影像杂志》2004年第11期601-603,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:评价MRI对脑内原发性恶性淋巴瘤的诊断价值。方法:收集经MRI检查并由手术病理证实的脑内原发性恶性淋巴瘤患者12例(其中5例做了增强MRI),回顾分析其MRI表现。结果:单发病灶10例、多发病灶2例,共检出病灶14个,幕上13个,幕下1个;大部分位于深部脑白质,其中累及额叶9个,侵及胼胝体6个,侵及室管膜2个;T1WI呈略低信号或等信号12个,T2WI全部呈等信号或略高信号。增强后“握拳”样强化2例,“团块”样强化3例。病灶直径大于5cm的5个,3～5cm的7个,小于3cm的2个。病灶周围轻度水肿7个,中度水肿6个,重度水肿1个。结论:尽管脑内原发性恶性淋巴瘤缺乏特征性的影像学表现,但全面分析其MRI表现,能够明显提高本病的诊断准确率。Objective: To evaluate the role of MRI in the diagnosis of primary malignant lymphomas in the brain. Methods: A retrospective analysis of MRI examinations was performed in 12 patients(5 of them were contrast-enhanced) with histologically proved primary malignant lymphomas in the brain. Results: Solitary lesion was found in 10 cases, and multiple lesions in 2 cases, altogether 14 lesions were identified(13 of them were within cerebral hemispheres and 1 in posterior fossa). Most of the lesions were within the subcortical white matter. Nine lesions involved frontal lobe, 6 lesions involved corpus callum and 2 lesions involved ependyma. On T1WI, 12 lesions were slightly hypointense or isointense while all of the lesions were isointense or slightly hyperintense on T2WI. Among the 5 cases who underwent enhanced MRI scans, 2 lesions were enhanced like fists, 3 lesions were enhanced like masses. The diameter of the lesion was greater than 5cm in 5 lesions, 3～5cm in 7 lesions, smaller than 3cm in 2 lesions. Seven lesions showed minimal edema, 6 lesions showed moderate edema and 1 lesion severe edema. Conclusion: Although there is no characteristic imaging findings of primary malignant lymphomas in the brain, the diagnostic accuracy could be highly improved if we analyze the MRI appearances fully.

关 键 词：淋巴瘤 脑肿瘤 磁共振成像 

分 类 号：R733[医药卫生—肿瘤] R739.41[医药卫生—临床医学]