MRI在原发性中枢神经系统淋巴瘤与脱髓鞘假瘤鉴别中的价值  

Significance of MRI in the differential diagnosis of primary central nervous system lymphoma and demyelinafing pseudotumors of brain

作　　者：卢善良 陈玉珊 林景恋 詹淑君 LU ShanLiang;CHEN Yushan;LIN Jinglian;ZHAN Shujun(Department of Imaging,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou,Fujian 363000,China)

机构地区：[1]福建医科大学附属漳州市医院影像科,漳州363000

出　　处：《福建医药杂志》2024年第4期1-5,共5页Fujian Medical Journal

基　　金：2021年福建省自然科学基金面上项目(2021J011409)。

摘　　要：目的探讨原发性中枢神经系统淋巴瘤(PCNSL)与脱髓鞘假瘤(DPTs)磁共振(MRI)的影像表现,提高两组疾病诊断准确性。方法回顾性分析41例中枢神经系统淋巴瘤和30例脱髓鞘假瘤的MRI检查,并分析两组MRI的影像学特征。结果PCNSL组与DPTs组在年龄、性别和临床症状上的差异无统计学意义(P>0.05),在病灶最大径、弥散加权成像(diffusion weighted imaging,DWI)、表观扩散系数(appearance diffusion coefficient,ADC)、磁敏感加权成像(magnetic susceptibility-weighted imaging,SWI)上存在统计学差异(P<0.05);PCNSL增强扫描呈明显均匀强化,部分病灶出现典型“缺口征”、“尖角征”,磁共振波谱分析(magnetic resonance spectroscopy,MRS)出现凋亡相关宽大Lip峰,可见Lac峰;DPTs增强扫描呈边缘环形轻度强化或无强化,MRS无特异性。结论PCNSL组的弥散受限、SWI信号减低发生率高于DPTs患者,结合增强扫描和MRS,可提高诊断准确性。Objective To investigate the imaging findings of magnetic resonance imaging(MRI)in the diagnosis of dc-myclinating pscudotumor and lymphoma of central nervous system and to improve the correct diagnosis rate of the disease.Methods A retrospective analysis of 41 patients with central nervous system lymphoma and 30 patients with dcmyclinating pscudotumor was carried out.MRI was performed on these patients and the imaging features were summarized.Results There was no statistically significant difference in age sex,and clinical symptoms (P>0.05).The MRI findings that showed statistical significance between the two groups included the maximum diameter,diffusion weighted imaging(DWI)combined with apparent diffusion coefficient(ADC),sensitive weighted imaging(SWI).Primary central nervous system lymphoma:MRI imaging features showed uniform enhancement characteristics after scan enhancement,manifested as“incision”and“angular”.And MRS showed highly elevated lipid peak and inverted lactic acid peak.Dcmyclinating pscudotumors:The lesions had round or no enhancement on MRI scan.And MRS showed no specificity.Conclusion The PCNSL group had a higher incidence of diffusion-limited and reducing SWI signal than patients with DPT's^which is of great value in improving the diagnostic accuracy of PCNSL andDPTs.Enhanced scanning and MRS also have diagnostic value in the two groups。

关 键 词：磁共振成像 中枢神经系统 脱髓鞘假瘤 淋巴瘤 鉴别诊断 

分 类 号：R733.4[医药卫生—肿瘤] R415.2[医药卫生—临床医学]