颅内原发性淋巴瘤DSC灌注成像的初步研究  

A Preliminary Study of Dynamic Susceptibility Contrast-Enhanced Perfusion Findings in Primary Intracranial Lymphoma

作　　者：廖伟华[1] 王小宜[1] 姜新雅[1] 陈长青[1] 王润文[1] 周高峰[1] 胡忠良[2] 

机构地区：[1]中南大学湘雅医院放射科,湖南省长沙市410008 [2]中南大学湘雅医学院病理学教研室

出　　处：《临床放射学杂志》2008年第8期1005-1009,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目分课题(编号:30370433)

摘　　要：目的探讨颅内原发性淋巴瘤动态对比磁敏感增强(DSC)灌注成像的特点。资料与方法采用平面回波(EPI)序列对9例颅内原发性淋巴瘤患者术前行DSC灌注成像,获得相对脑血容量(rCBV)图、相对脑血流量(rCBF)图、平均通过时间(MTT)图和时间-信号曲线,并计算肿瘤实质最大rCBV比值和MTT比值,结合病理特征与14例高级别(Ⅲ、Ⅳ级)星形细胞瘤作对照。结果颅内原发淋巴瘤肿瘤实质最大rCBV比值为1.71±0.59,而高级别星形细胞瘤肿瘤实质最大rCBV比值为5.17±1.73,两者差异有统计学意义(P<0.001),但两组病例肿瘤实质MTT比值间的差异无统计学意义(P=0.101)。颅内原发性淋巴瘤肿瘤实质时间-信号曲线首过期后曲线超过基线水平,高级别星形细胞瘤肿瘤实质时间-信号曲线回复基线前可出现一个小的再下降波形,且首过期后曲线均未超过基线水平。颅内原发性淋巴瘤瘤细胞密集,核大浓染,胞质少,可见瘤细胞围绕血管呈"袖套"状排列,肿瘤血管内皮增生少见。高级别星形细胞瘤可见大量肿瘤血管。结论颅内原发淋巴瘤DSC灌注成像呈相对低灌注,肿瘤实质最大rCBV比值低于高级别星形细胞瘤,且时间-信号曲线有别于高级别星形细胞瘤,是由两者不同的病理学基础决定,DSC灌注成像有助于提高颅内原发性淋巴瘤的MRI诊断能力。Objective To study dynamic susceptibility contrast-enhanced （DSC） perfusion-weighted imaging features of primary intracranial lymphomas. Materials and Methods DSC perfusion-weighted imaging scans were performed by echoplanar imaging（EPI）. The rCBV map, rCBF map, MTT map and intensity-time curve were obtained, and the maximum rCBV ratio and MTT ratio of tumor parenchyma were calculated in 9 cases of intracranial lymphomas. DSC perfusion-weighted imaging features and histological results of 9 intraeranial lymphomas were compared with 14 cases of high grade （ Ⅲ, Ⅳ ） astrocytomas. Results The maximum rCBV ratio of primary intraeranial lymphomas was 1.71 ± 0.59, while that of high grade astroeytomas was 5.17 ± 1.73. The primary intraeranial lymphoma had a tendency to have relatively low perfusion compared with high grade astroeytomas （ P 〈 0.001 ）. The differences of MTY ratio between primary intraeranial lymphomas and high grade astroeytomas showed no statistical significance （P = 0. 101 ）in tumor parenehyma. The intensity-time curve of primary intraeranial lymphomas exceeded the baseline after first-pass, while the intensity-time curve of high grade astroeytomas never exceeded the baseline after first-pass, and a little decrease wave was identified before curve reach the baseline. The primary intraeranial lymphomas showed a hypereellular neoplasm, and the tumor cells infiltrating round the vessels were identified while the formation of tumor neovaseularization is absent. The high grade astroeytomas showed abundant tumor neovaseularization. Conclusion Primary intraeranial lymphomas have relatively low rCBV values. The different manifestations between rimary intraeranial lymphomas and high grade astroeytomas, such as the maximum rCBV ratio of primary intracranial lymphomas is lower than that of high grade astrocytomas and the intensity-time curve of primary intracranial lymphomas is different from that of high grade astroeytomas, is determined by their different histopathologieal eharae-ter

关 键 词：淋巴瘤 颅内 磁共振成像 灌注加权成像 

分 类 号：R739.4[医药卫生—肿瘤]