多模态MR成像对原发性脑淋巴瘤的诊断价值  

The Value of Multi-mode MR Imaging in the Diagnosis of Primary Brain Lymphoma

作　　者：李刚锋[1] 余美 孙颖志[1] 王文[1] 胡玉川[1] 崔光彬[1] LI Gang-feng;YU Mei;SUN Ying-zhi(Department of Radiology,Tangdu Hospital,Fourth Military Medical University,Shaanxi Provincial Key Laboratory of functional and molecular imaging,Xi'an 710038,Shaanxi Province,China)

机构地区：[1]第四军医大学唐都医院放射科,陕西省功能与分子影像重点实验室,陕西西安710038

出　　处：《中国CT和MRI杂志》2020年第12期22-25,F0002,共5页Chinese Journal of CT and MRI

摘　　要：目的探讨多模态MR成像对原发性脑淋巴瘤的诊断价值。方法回顾性分析经病理证实的27例原发性脑淋巴瘤患者的多模态MR图像。所有患者均在治疗前行MR扫描,序列包括:T1WI、T2WI、增强T1WI、DWI、MRS及3D-ASL。观察并总结原发性脑淋巴瘤在不同序列中的表现及信号特征。结果27例中19例单发,8例多发,共50个病灶,其中幕上41个,幕下9个。病灶多位于近中线深部的脑实质区,T1WI呈稍低或等信号,T2WI呈稍高或等信号,DWI呈高或稍高信号。增强扫描37个病灶呈较均匀强化,13个病灶因内部有囊变坏死而强化不均匀,其中14个病灶出现“尖突征”,8个病灶出现“脐凹征”,6个病灶出现“握拳征”,5个病灶出现“蝶翼征”。MRS示肿瘤实质区Cho峰明显升高,NAA峰中度或显著降低,Cr峰轻度降低,部分肿瘤可见Lip峰。3D-ASL示肿瘤实质区CBF较健侧脑实质减少。结论多模态MR成像对原发性脑淋巴瘤的定性诊断具有较高价值。Objective To investigate the value of multi-mode magnetic resonance imaging(MRI)in the diagnosis of primary brain lymphoma.Methods The multimodal MR images of 27 patients with primary brain lymphoma confirmed by pathology were analyzed retrospectively.All patients underwent multi-mode magnetic resonance scanning including T1WI,T2WI,enhanced T1WI,DWI,MRS,3D-ASL before any treatment.The morphology features and signal intensity characteristics in different sequences were evaluated.Results In all of 27 cases,19 cases have solitary lesions,and 8 cases have multiple lesions.50 lesions were found in total,in which 41 lesions were supratentorial,and 9 lesions were infratentorial.Most of the lesions were located in the deep brain adjacent to the mid-line.The lesions showed slightly low-or iso-signal intensity in T1WI,slightly high-or iso-signal intensity in T2WI,and high or slightly high signal intensity in DWI.All of the lesions were enhanced significantly,in which 37 lesions presented homogeneous enhancement,the rest of the lesions showed heterogeneous enhancement because of central necrosis;and in which 14 lesions appeared"tips sign",8 lesions appeared"umbilical concave requisition",6 lesions appeared"fist sign",5 lesions appeared"butterfly sign".In all cases,MRS showed that Cho was increased obviously,NAA was decreased moderately or significantly,Cr was decreased slightly,some lesions presented Lip peak.3D-ASL indicated that the CBF of lesions was decreased,compared with the normal brain parenchyma.Conclusion Multimodal MR imaging has high value in the qualitative diagnosis of primary brain lymphoma.

关 键 词：磁共振成像 脑肿瘤 淋巴瘤 

分 类 号：R739[医药卫生—肿瘤] R445[医药卫生—临床医学]