原发性中枢神经系统淋巴瘤的CT影像特征分析  

CT features of primary central nervous system lymphoma

作　　者：范梦珂 张旭东[1] 赵璐[1] 陈清江[1] 张明智[1] 杨志浩[1] FAN Mengke;ZHANG Xudong;ZHAO Lu;CHEN Qingjiang;ZHANG Mingzhi;YANG Zhihao(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000,China)

机构地区：[1]郑州大学第一附属医院肿瘤科,郑州450000

出　　处：《临床血液学杂志》2023年第11期819-823,共5页Journal of Clinical Hematology

基　　金：国家自然科学基金面上项目(No:82070210);河南省医学科技攻关重大项目(No:SBGJ202001008)。

摘　　要：目的:分析原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)的CT影像学特征,为基层医院对PCNSL的初步诊断及鉴别诊断提供参考。方法:收集郑州大学第一附属医院经病理证实的70例初诊PCNSL患者的CT资料,分析其病灶密度特征、发生部位、占位效应、病灶形态、数目、大小、瘤周水肿程度等CT影像学特征。结果:70例PCNSL患者中女34例(48.6%),男36例(51.4%),发病年龄30~82岁,肿瘤的发病部位多在基底节区(34.3%)、额叶(31.4%)、颞叶(28.6%),其中病灶累及多部位的患者39例;CT表现边缘多清晰(94.3%),多呈稍高密度(84.3%),病灶多呈团块状(92.9%),大多数肿瘤病灶周围可见不同程度的水肿(95.7%)及不同程度的占位效应(61.4%),CT平扫图像可见特殊征象(如脐凹征、握拳征、蝶翼征、勒痕征、尖角征);病灶直径为(37.3±1.7)mm;CT值中位数为39.2(36.4,42.3)Hu;CT增强扫描则均表现为明显强化。结论:PCNSL患者CT影像学多表现为边缘清晰的团块样病灶,多为等密度或稍高密度,且在部分患者中可见特殊征象,对其初步诊断有提示性意义。Objective To analyze the CT image features of primary central nervous system lymphoma(PCNSL)and provide a useful reference for the initial and differential diagnosis of PCNSL in primary hospitals.Methods The CT data of seventy untreated patients with PCNSL confirmed by pathology in the First Affiliated Hospital of Zhengzhou University were collected.The CT imaging features of the site,density,peritumoral edema,mass effect,number,size,distribution and morphology of the lesions were analyzed.Results Among 70 patients with PCNSL,34 cases(48.6%)were female and 36 cases(51.4%)were male.The age of onset was 30-82 years old.Most of the tumor sites were in basal ganglia region(34.3%),frontal lobe(31.4%)and temporal lobe(28.6%).CT showed clear edges(94.3%),slightly high density(84.3%),mass(92.9%),and peritumoral edema to varying degrees(95.7%)and mass effect to varying degrees(61.4%).Plain CT images showed special signs(e.g.umbilical concave signs,clenched fist sign,butterfly wing sign,gap signs,sharp angle sign).The diameter of the lesion was(37.3±1.7)mm.The median CT value was 39.2(36.4,42.3)Hu.All the enhanced scans showed obvious enhancement.Conclusion The CT imaging findings of PCNSL patients were mostly clear-edging mass lesions in equal or slightly high density,and some special signs could be seen,which has suggestive significance for the initial diagnosis.

关 键 词：原发性中枢神经系统淋巴瘤 影像诊断 计算机体层成像 

分 类 号：R733.4[医药卫生—肿瘤]