原发性中枢神经系统淋巴瘤的影像诊断及鉴别诊断  

Imaging diagnosis and differential diagnosis of primary central nervous system lymphoma

作　　者：王爱华[1] 

机构地区：[1]德州市人民医院放射科,山东 德州253014

出　　处：《实用放射学杂志》2015年第10期1598-1600,共3页Journal of Practical Radiology

摘　　要：目的：探讨原发性中枢神经系统淋巴瘤（PCNSL）的 MRI 和 CT 表现及影像特征,以提高诊断和鉴别诊断水平。方法回顾性分析11例经手术病理证实的 PCNSL 影像学表现。结果单发病灶9例,2例为多发病灶,肿瘤多位于脑深部或临近脑膜,额叶2例,胼胝体2例,临近脑膜2例,枕叶3例；CT 平扫呈等或略高密度,MRI 平扫 Tl WI 呈稍低或等信号,T2 WI 呈等或稍高信号；增强扫描病变均明显强化,2例见脑膜强化,1例见室管膜强化；肿瘤占位效应轻,多数轻中度水肿,2例为重度水肿；7例见典型的脐凹征、棘征、分叶征、缺口征（握拳征）、半月征等。结论PCNSL 的影像学表现有一定的特征性,MRI 在其定位和定性诊断中具有重要价值。Objective To study MRI and CT manifestations and characteristics of primary intracranial lymphoma,and improve the diagnosis and differential diagnosis.Methods Imaging features of primary intracranial lymphoma in 1 1 patients proved by pathology were analyzed retrospectively.Results 9 cases were solitary tumor and 2 cases multiple lesions.Tumors were located in the frontal lobe in 2 cases,the corpus callosum 2 cases,near meningeal 2 cases,the occipital lobe 3 cases.Tumors presented as isodensity or slight hyper density on CT and equal or slight long T1 and T2 signal on MRI.All the lesions were found with obvious homogenous en-hancement;in which 2 cases were found meningeal strengthened;1 case room tube film strengthened.There were slight space occup-ing effect,mostly mild to moderate edema,severe edema in 2 cases.7 typical cases presented “umbilicus sign”,“notch sign”,“lobu-lated”,“incision sign （fist sign）”,and “half month”and so on.Conclusion Imaging manifestations of primary intracranial lymphoma has certain specificity and MRI plays an important role in making accurate diagnosis in the position and qualitative diagnosis.

关 键 词：原发性淋巴瘤 中枢神经系统 影像 诊断 

分 类 号：R734.9[医药卫生—肿瘤] R814.4[医药卫生—临床医学]