胼胝体压部弥散加权成像高信号病变的MRI鉴别诊断

摘要

目的:探讨磁共振成像(MRI)鉴别诊断胼胝体压部弥散加权成像(DWI)高信号病变的临床价值.方法:收集53例[男性28例,女性25例,平均(47.21±21.12)岁]累及胼胝体压部呈DWI高信号病变的MRI和临床资料,回顾性分析其临床表现和MRI影像特征.结果:胼胝体压部的非肿瘤性病变39例(73.6％),肿瘤性病变14例(26.4％).非肿瘤性病变MRI表现为T1WI呈稍低或等信号,T2WI和FLAIR呈高信号,DWI呈高/明显高信号,病灶边界清晰或模糊,形态不一,呈孤立局限性或弥漫性改变;肿瘤性病变MRI表现为呈长或稍长T1长T2信号,部分区域为水肿累及所致,病灶实性部分DWI呈高信号,增强扫描呈不规则强化.结论:累及胼胝体压部中DWI高信号病变的临床表现缺乏特异性,根据临床资料结合MRI其他表现一般可定性诊断并做出鉴别诊断.%Objective To discuss the clinical value of magnetic resonance imaging (MRI) in the differential diagnosis of high signal lesions in the splenium of corpus callosum (SCC) which are shown on diffusion weighted image (DWI).Methods The clinical manifestations and MRI findings of 53 patients with DWI high signal lesions in SCC,including 28 male and 25 female,with a mean age of (47.214±21.12) years,were analyzed retrospectively.Results In SCC,non-neoplastic lesions were found in 39 cases (73.6％) and neoplastic lesions in 14 cases (26.4％).The non-neoplastic lesions showed iso-or slightly low signal intensity on T1-weighted images,high signal intensity on T2-weighted images and fluid-attenuated inversion recovery images,and high or significantly high signal intensity on DWI.The non-neoplastic lesions were diffused or isolated focal lesions with clear or blurry boundaries and various shapes.The neoplastic lesions showed long or slightly long-T1 and T2 signals which were caused by edema in some areas,DWI high signal intensity in the solid portions,and irregular contrast-enhancement.Conclusion The clinical manifestation of DWI high signal lesions with SCC involvement was lack of specificity,and the high signal lesions can be generally diagnosed and identified according to the MRI findings and clinical data.