原发性脑B细胞性淋巴瘤的DWI及MR多时相增强对比研究  

Comparative study in primary brain B-cell lymphoma using diffusion weighted imaging and multi-phases contrast enhancement of MR

作　　者：刘干辉[1] 陈振松[1] 程英[1] 陈业媛[2] 王宏琢[1] 孙莞琴[1] 蔡树丰 杨丽娟[1] 龚洪翰[2] 潘高升[1] 

机构地区：[1]粤北人民医院放射科,广东韶关512026 [2]南昌大学第一附属医院放射科,江西南昌330006

出　　处：《中国临床医学影像杂志》2013年第8期533-536,共4页Journal of China Clinic Medical Imaging

摘　　要：探讨和分析原发性脑B细胞性淋巴瘤MR影像特点,提高诊断的准确率。方法:将MR平扫脑内有单发肿块的71例患者,给予DWI扫描,同时分别在造影剂注射后,应用25 s、125 s和185 s三个时相进行增强扫描。根据病理资料,将所有患者分组,并测量各组ADC值、平扫时的信号强度和增强后不同时相病灶的信号强度,将所有数据进行比较分析。结果:71例中58例患者具备完整的病理资料,其中包括原发性脑B细胞性淋巴瘤12例、胶质母细胞瘤20例、肺腺癌脑转移26例。将原发性脑B细胞性淋巴瘤、胶质母细胞瘤及肺癌脑转移瘤的ADC值及平扫信号强度进行组间比较,均无统计学意义。将原发性脑B细胞性淋巴瘤三个增强时相的平均信号强度进行比较,25 s和125 s时相相关系数为1.0,有统计学差异,25 s与185 s时相及125 s与185 s时相相关系数分别为0.992、0.994,无统计学意义。原发性脑B细胞性淋巴瘤与胶质母细胞瘤有5个时相点有鉴别意义,而与肺腺癌脑转移中有11个时相点有鉴别意义。结论:应用MR多时相增强扫描,有助于鉴别原发性脑B细胞性淋巴瘤、胶质母细胞瘤及肺腺癌脑转移,而ADC值无鉴别价值。Objective： To investigate MRI characteristics of the primary brain B-cell lymphoma （PBBL） so as to diagnose accurately. Methods： Seventy-one patients underwent MRI examination, and they were found to have the single mass in their brain, and then all patients were performed diffusion weighted imaging and contrast enhanced examination at 25 s, 125 s and 185 s after contrast injection, respectively. Depending on pathological data, all patients were divided into groups, ADC values and signal intensity of non-contrast and contrast examination were measured and compared. Results： Fifty-eight patients had entire pathological data and were divided into three groups, including twelve patients with PBBL, 20 glioblastoma and 26 brain metastasis from lung cancer. For all groups, there were no statistical differences found among ADC values and signal in- tensity in non-contrast examination（P〉O.05）. In all phases of contrast enhancement examination, mean signal intensity of PBBL were compared with those of the other two groups respectively, relative coefficient between 25 s and 125 s was 1.0, differences were significant（P〈O.05）, whereas those between 25 s and 185 s, between 125 s and 185 s were not significant（P〉0.05）. The sig- nal intensity of PBBL at all phases of contrast enhancement was compared with that of glioblastoma, differences were signifi- cant in 5 phase points, but compared with brain metastasis of lung cancer, those of PBBL at l 1 phase ponts were significant and could be used differential diagnosis. Conclusion： MRI examination by multi-phases contrast enhancement is able to pro- vide more information for differentiating PBBL from glioblastoma and brain metastasis of lung cancer. Meantime, we find that ADC value is not useful to make differential diagnosis of PBBL and other tumors.

关 键 词：淋巴瘤 B细胞 脑肿瘤 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤]