MRI应用于原发性颅内恶性淋巴瘤鉴别诊断的临床价值  

Clinical value of MRI in differential diagnosis of intracranial malignant lymphoma

作　　者：肖燕[1] 杨宇洁[1] 

机构地区：[1]四川省肿瘤医院影像科,四川成都610041

出　　处：《现代医学》2015年第11期1384-1387,共4页Modern Medical Journal

摘　　要：目的:总结原发性颅内恶性淋巴瘤的磁共振成像(MRI)表现特点,并总结有助于与颅内恶性胶质瘤及转移瘤进行鉴别诊断的表现,以使颅内的恶性淋巴瘤临床诊断正确率得以提高。方法:对25例通过手术病理或临床随访证实的颅内原发性恶性淋巴瘤患者MRI资料进行回顾性分析,将MRI影像表现同非淋巴瘤组(颅内恶性胶质瘤25例和转移瘤25例)进行对比。观察以下几个方面:(1)肿瘤所在部位、总体数目和多发病灶分布的总体特征。(2)肿瘤的信号、形态特点和病灶内的坏死囊变。(3)肿瘤的弥散加权成像(DWI)及表观弥散系数(ADC)图。结果:颅内恶性淋巴瘤可单发或多发,T1加权图像上呈等或低信号,T2加权图像呈稍低、等或高信号,肿瘤信号较均匀,增强扫描大多呈明显均匀强化,瘤周脑水肿明显,DWI(b=1 000)呈均匀高信号。颅内恶性淋巴瘤好发于深部脑组织,多发病灶呈区域性分布,病灶内坏死囊变灶少,ADC图呈低信号或以低信号为主,这些特点在颅内恶性淋巴瘤与非淋巴瘤之间差异有统计学意义(P<0.05)。结论:颅内的恶性淋巴瘤有多样表现,然而MRI特征较为典型,正确认识其MRI特点可以使诊断的正确率得到明显提高。Objective： To summarize the MRI features of intracranial malignant lymphoma and determine the useful findings in differential diagnosis of malignant gliomas and metastatic tumors. Methods： MRI materials of 25 patients with intracranial malignant lymphoma confirmed by pathology and clinical dates were retrospectively reviewed. These MRI materials were then compared with the MRI materials in a non-lymphoma groups which contained malignant gliomas （ n = 25 ） and metastasis （ n = 25 ）. Observing factors included ： （ 1 ） Location, number and distributing of lesions. （2） Signal, morphologic features, and necrosis of the lesion in the tumor. （3） Diffusion-weighted MRI Imaging （DWI） and apparent diffusion coefficient（ADC） imaging of tumors. Statistic test was performed to compare the differences in two groups. Results： The intracranial malignant lymphoma may be single or multiple,lesions presented as isointense or hypointense on T1-weighted images, and slight hypointense or isointense or hyperintense on T2-weighted images, most of the enhancement scan was obviously enhanced, and the brain edema was obvious, lesions showed homogeneously high signal on DWI （ b = 1 000）. Intracranial malignant lymphoma was well distributed in deep brain tissue, multiple lesions were distributed in a region. There was a lack of necrotic cystic foci in the lesions. ADC image showed hypointense or hypointense priority. These features showed significant difference between intracranial malignant lymphoma and non lymphoma patients （P 〈 0.05 ）. Conclusion： Intracranial malignant lymphoma has a variety of manifestations, however, the characteristics of MRI are typical. Correct understanding of the characteristics of the MRI can increase the correct rate of the diagnosis significantly.

关 键 词：脑肿瘤 淋巴瘤 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R733[医药卫生—临床医学]