摘要
目的探讨磁共振成像(MRI)技术在原发性中枢神经系统淋巴瘤(PCNSL)诊断及临床应用的价值。方法回顾性分析17例经手术病理证实的原发性中枢神经系统淋巴瘤的MRI表现。结果 17例患者中,13例单发,4例多发,共计23个病灶,幕上20个,幕下3个,其中,脑室旁深部白质区6个,基底节区4个,胼胝体4个,背侧丘脑3个,大脑皮层下白质区2个,侧脑室内1个,脑干1个,小脑蚓部2个。MRI平扫T1WI呈等、稍低信号影,T2WI呈等、稍高信号影,液体衰减反转恢复(FLAIR)序列呈高信号影,DWI呈高信号影。增强扫描15例肿瘤实质明显强化,信号均匀,可呈现缺口征,握拳征(握指征),蝶翼征,硬环征等,2例呈环形强化。PWI显示17例均呈低灌注状态。7例行MRS检查,出现NAA峰减低或消失,Cho峰升高,出现高耸的Lip峰,部分出现Lac峰。结论磁共振成像在原发性中枢神经系统淋巴瘤的诊断中具有一定的特征性表现,具有较高的诊断应用价值。
Objective To discuss the diagnostic and clinical application value of MRI in PCNSL.Methods MRI performance of PCNSL in 17 cases which were confirmed by surgery and pathology were retrospectively analyzed.Results Among 17 cases,there were13 cases with simple PCNSL,4 cases with multiple PCNSL.The amount of lesions was 23 which included 20 cases of supratentorial tumor and 3 cases of subtentorial tumor.And there were 6 cases happened in deep white matter area of ventricles of brain,4 cases in basal ganglia,4 cases in corpus callosum,3 cases in dorsal thalamus,2 cases in subcortical white matter area,1 cases in lateral ventricle,1 cases in brainstem,1 cases in vermis.T1 WI showed slightly low signal shadow through MRI plain scan,T2 WI showed slightly high signal shadow,fluid attenuated inversion recovery（FLAIR） sequence showed high signal intensity,DWI showed a high signal shadow.15 cases of tumor parenchyma was significantly enhanced through enhanced scan,with uniform signal,which might present a gap,a sign（holding indication）,butterfly sign,hard ring sign etc,2 cases showed ring enhancement.PWI showed 17 cases were in low perfusion state.7 cases given MRS examination,NAA peak appeared to reduce or disappear,with Cho peak elevation and the emergence of towering peaks of Lip and part of the emergence of Lac peak.Conclusion MRI had certain characteristic performance in the diagnosis of PCNSL.It has a high diagnostic value.
出处
《新疆医学》
2016年第10期1287-1290,共4页
Xinjiang Medical Journal
关键词
原发性
中枢神经系统
淋巴瘤
磁共振成像
Primary
Central nervous system
Lymphoma
Magnetic resonance imaging
