原发性中枢神经系统淋巴瘤的临床及MRI特征分析  

Analysis of the clinical and magetic resonance imaging features in patients with primary central nervous system lymphomas

作　　者：李志超[1] 王亚明[1] 田增民[1] 卢旺盛[1] 张剑宁[1] 

机构地区：[1]海军总医院神经外科,北京100048

出　　处：《中国临床神经外科杂志》2014年第10期584-586,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨原发性中枢神经系统淋巴瘤（PCNSL）患者影像学特征和临床特点,为其临床诊治提供帮助。方法 2007年6月至2011年12月立体定向活检活检术确诊PCNSL患者122例（淋巴瘤组）,随机抽取同期40例非淋巴瘤患者（非淋巴瘤组）作为对照,其中胶质瘤27例,转移瘤13例;比较分析两组患者影像学特征。结果 122例PCSNL患者中,50-70岁67例（55.0%）,头痛、头晕71例（58.2%）,单发病灶67例（54.9%1）,幕上病灶109例（89.3%）,累及基底节56例（45.9%）。两组患者MRI特征比较：淋巴瘤组病灶靠近中线和或脑室者所占比例（82.8%）明显高于非淋巴组（52.5%;P〈0.05）;淋巴瘤组占位程度呈轻、中度者所占比例（95.1%）明显高于非淋巴瘤组（80.0%;P〈0.05）;淋巴瘤组＂握雪团样强化＂患者所占比例（29.5%）明显高于非淋巴瘤组（0;P〈0.05）;非淋巴瘤组环形强化比例（62.5%）明显高于淋巴瘤组（3.3%,P〈0.05）。结论 PCSNL以50-70岁为发病高峰,罕有癫痫;病灶多位于幕上,多发常见;好发于侧脑室旁等靠近脑内中线部位;通常伴有轻、中度水肿,而移位程度不明显;与其他颅内恶性肿瘤相比,＂握雪团＂样强化是PCNSL的MRI特征性表现。Objective To investigate clinical and magetic resonance imaging （MRI） features in the patients with primary central nervous system lymphomas （PCNSL） in order to provide useful data for the clinical management. Methods The clinical data of 122 patients with PCNSL who were treated from June, 2007 to December, 2011 were analyzed retrnspectively, including clinical manifestation, imaging feature and so on. Results Male sex to female sex was 1.4 to 1.0 in these patients with PCNSL. The patients aged from 50 to 70 years accounted for 55.0% of 122 patients with PCNSL. There was single lesion in 54.9%, and multiple lesions in 45.1% of the patients with PCNSL. There were supertentorial lesions in 89.4%, infratentorial lesions in 4.1%, supertentorial and infratentorial lesions in 6.6% of these patients. After administration of contrast material, 29.5% of lesions exhibited intense snow mass-shaped contrast enhancement, 67.2% mass-shape enhancement and 3.3% ring-shaped enhancement on MRI. Conclusions PCNSL is more common in the male than that in the female. The most lesions are in the supertentorial regions and the middle line cerebral region nearby the lateral ventricle. The peak prevalence of PCNSL occurs from the 5th to 7th decades of life. Seizure is rare in the patients with PCNSL. The moderate and severe edema is common, but the shift of the cerebral middle line is slight. The intense grip snow mass-shaped enhancement is a characteristic of the MRI in the patients with PCNSL.

关 键 词：原发性中枢神经系统淋巴瘤 临床特点 影像学特征 

分 类 号：R739.41[医药卫生—肿瘤]