原发性脑内恶性淋巴瘤伽玛刀治疗前后MRI特征分析  

MRI features before and after gamma knife treatment of primary lymphoma of the brain

作　　者：宋文[1] 余长亮[1] 王海宝[1] 

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022

出　　处：《安徽医药》2014年第2期285-287,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的通过回顾性分析9例经病理证实的原发性脑淋巴瘤γ刀治疗前后磁共振(MR)特点,探讨MR在原发性脑淋巴瘤诊断和治疗后评估中的价值。方法 9例原发性脑淋巴瘤γ刀治疗前后行MR平扫、增强、磁共振波谱(MRS)检查,对其磁共振影像特点进行分析,并运用配对t检验比较经γ刀治疗前后MRS各峰下化学物质含量的均值是否有差异。结果该组共9例原发性脑淋巴瘤。6例单发,3例多发,T1WI显示4例呈等信号,5例呈低信号,T2WI显示4例呈等信号,5例呈高信号,增强后病灶均明显强化,其中4例可见握拳征,经γ刀治疗后病灶均明显缩小或消失;9例MRS显示:胆碱(Cho)升高,N-乙酰天冬氨酸(NAA)降低,4例见脂质(Lip)峰;与治疗前波谱比较显示:Cho降低,NAA升高;比较治疗前后NAA、Cho各含量及NAA/Cr、Cho/Cr的均值,两者间差异显著(P<0.05)。结论综合分析MRI及MRS特点对于原发性脑内淋巴瘤临床诊断和γ刀治疗后评估具有一定的价值。Objective Through the retrospective analyses on MRI features in 9 patients pathologically diagnosed with primary cerebral malignant lymphoma（ PML） and treated with gamma knife,to explore the value of MRI in the PML diagnosis and treatment assessment. Methods MRI plain scan,enhancement scan and MRS were adopted in the 9 PML patients treated with gamma knife. We analyzed MRI features and used paired t-test to examine the differences of mean peak values of the chemical compound content in the treatment. Results There were 9 cases including 6 single lesion cases and 3 cases with multiple lesions. On T1WI,4 cases showed isointensity lesions and 5 cases hypo-intensity lesions. On T2WI,4 cases showed iso-intensity lesions and 5 cases hyper-intensity lesions. All of lesions were highly enhanced with contrast and 4 cases showed＂fist sign＂. After gamma-knife treatment lesions significantly reduced or disappeared. As for MRS,9 cases showed increased Cho and reduced NAA and 4 cases had lip summit. Contrast to pretreatment spectrum,Cho peak decreased and NAA peak increased. There were significant differences in the mean of NAA peak,Cho peak and NAA / Cr and Cho / Cr between pretreatment and post treatment（ P ＆lt; 0. 05）. Conclusions Comprehensive analyses of MRI and MRS features have great value in the primary cerebral lymphoma clinical diagnosis and treatment assessment.

关 键 词：淋巴瘤 磁共振波谱分析 Γ刀 

分 类 号：R739.41[医药卫生—肿瘤]