原发性颅内B细胞淋巴瘤磁共振弥散加权成像与~1H-MRS表现的相关性  

Correlation Between MR Spectrum and Diffusion Weighted Imaging in the Diagnosis of Primary Intracranial B-cell Lymphoma

作　　者：陈峰[1] 刘涛[2] 李建军[1] 李岩[1] 李长清[1] 王飞[1] 陈旺生[1] 许琴[1] 

机构地区：[1]海南省人民医院放射科,海南海口570311 [2]海南省人民医院神经内科,海南海口570311

出　　处：《武汉大学学报（医学版）》2014年第3期398-402,共5页Medical Journal of Wuhan University

基　　金：海南省卫生厅重点计划项目(编号:琼卫2012ZD-09;琼卫2012ZD-06)

摘　　要：目的:探讨免疫功能正常人原发性颅内B细胞淋巴瘤磁共振(MR)弥散加权成像(DWI)及多体素质子磁共振波谱成像(1 H-MRS)表现及二者的相关性。方法:回顾性分析15例经病理证实的原发性颅内B细胞淋巴瘤的MRI表现,其中10例患者均行DWI和1 H-MRS检查,分别测量肿瘤实质表观弥散系数(ADC)、胆碱/N-乙酰天门冬氨酸(Cho/NAA)、脂质/肌酸(Lip/Cr)比值,并探讨ADC与Cho/NAA、Lip/Cr的相关性。结果:15例患者共检出23个病灶,病灶T1WI呈稍低信号,T2WI呈等或稍高信号,增强后病灶多明显均匀强化,"尖角征"和"缺口征"的出现具有特异性。10例均行DWI和三维多体素1 H-MRS检查,共检11个病灶,肿瘤实质区ADC值较对侧正常脑实质明显降低,分别为(0.000 773±0.000 096)mm2/s,(0.000 900±0.000 165)mm2/s,二者的差异有统计学意义(t=2.611,P=0.017)。肿瘤实质区Cho峰升高,NAA降低,并出现高耸的Lip峰,测量肿瘤实质区Cho/NAA均值1.99±0.25,对侧正常脑区Cho/NAA均值0.82±0.09,二者的差异有统计学意义(t=14.743,P=0.00);肿瘤实质区出现高耸的Lip峰。ADC值与Cho/NAA比值呈负相关(r=-0.687,P=0.02)。结论:原发性颅内B细胞淋巴瘤ADC值降低,Cho/NAA升高,ADC值与Cho/NAA比值呈负相关性,MRI表现具有一定的特征,多序列联合应用可提高MRI对肿瘤的诊断水平。Objective： To retrospectively analyze the correlation between 1H-MR spectroscopy （IH_ MRS） and diffusion weighted imaging（DWI） in primary intracranial lymphoma patients with normal immunological function. Methods： The MRI features were retrospectively analyzed in 15 cases of B-cell primary intracranial lymphoma proved by operation and pathology, while 1H-MRS and DWI features of 10 cases were retrospectively studied. The Cho/NAA, Lip/Cr value and its corresponding apparent diffusion coefficient（ADC） value in each region were measured and compared. Results. 23 nodules were detected in all 15 patients. The lesions showed isointensity on T1WI,and isointensity or slightly hyperintensity on T2WI. Most lesions demonstrated obvious in- tense and homogenous enhancement, the presence of incision sign and angular sign were more specified. The ADC value of primary intracranial lymphoma was （0. 000 773±0. 000 096） mm2/ s, and its comparison with normal contralateral cerebral parenchyma （0. 000 900 ± 0. 000 165 mm2/s） showed a statistical significance decrease in the ADC value（t=2. 611 ,P=0. 017） in 11 le- sions of all 10 patients. 1H-MRS showed decreased NAA and elevated choline （Cho） with large lipid peak. The Cho/NAA value of primary intraeranial lymphoma was 1.99±0.25, and the com- parison with normal contralateral cerebral parenchyma（0.82 ± 0.09） showed a statistical signifi- cance increase in the Cho/NAA value（t=14. 743 ,P=0.00） in the same 11 lesions. ADC value had negative correlation with the ratio of Cho/NAA（r=- 0. 687, P = 0.02）. Conclusion： ADC value was decreased and Cho/NAA ratio was increased in primary intracranial lymphoma, and ADC value had negative correlation with the ratio of Cho/NAA in lesions. Combining with the DWI with 1H-MRS features can improve MRI diagnostic accuracy of primary intracranial lymphoma.

关 键 词：淋巴瘤 磁共振成像 表观弥散系数 磁共振波谱成像 弥散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]