颅内原发性淋巴瘤MRI及PET-CT表现

摘要

Objective To analyze the MRI and F18_FDG PET-CT appearances of intracranial primary lymphoma.Methods The MRI and F18_FDG PET-CT of 21 patients (14 men, 7 women, age range: 28 t0 84 years, mean: 53 years) with histologically confirmed IPL were analyzed retrospectively. The tumor location, size, shape, signal intensities on T1- , T2- and FLAIR-weighted MR images , contrast enhancement characteristics, peiritumoral edema and necrosis were assessed. Results Of 15 patients over the age of 50 years,6 patients (28.6%) had solitary lesions and 15 patients (71.4%) had multifocal disease yielding a total of 70 lesions. 90% of the lesions were located in the corpus callosum, basalrnganglia , thalamus and periventricular regions. 62.9 0f lesions were irregular. The tumor spread along V-R spaces ( 36.4%) ,rnwhite matter (52.3%) , gray matter and meninges. Most lesions were slightly hypointense or isointense on TiWI (88.5% ) ,rnand slightly hyperintense or isointense on T2WI (97.1% ) relative to gray matter, and showed obvious enhancement rn(75.7%). The tumor was hyper-metabolic in 8/9 (88.9%) of patients on F18_FDC PET-CT. Conclusion Intracranial primary lymphoma has characteristic features on MRI and 18FDG PET-CT, which are helpful for preoperative diagnosis.%目的 分析颅内原发性淋巴瘤(IPL)的MRI及PET-CT表现,提高颅内原发性淋巴瘤的术前诊断准确率.方法 回顾性分析21例颅内原发性淋巴瘤的临床表现及影像学资料,重点分析病灶的MRI表现,包括肿瘤的位置、大小、形态及各序列上的信号特点及强化特点、瘤周水肿、瘤内坏死情况及FDG代谢情况.所有病例均经病理组织学证实.所有病例均行MRI平扫及增强扫描,其中9例行PET-CT检查.结果 21例患者中,男14例,女7例,年龄28～84岁,其中50岁以上者15例(约71％).共发现70个病灶,单发病灶6例,多发病灶15例;大部分病灶位于中线区域(胼胝体、基底节、丘脑、侧脑室旁)；62.9％病灶形态不规则,沿血管间隙、脑回、白质束、脑膜浸润,呈现多种形态.88.5％病灶T1WI上为稍低信号或等信号,T2WI稍高信号或等信号(97.1％)；增强后明显强化(75.7％).18FDG PET-CT上8例表现为均匀高代谢.结论 大多数颅内原发性淋巴瘤常规MRI平扫及增强及18FDG-PET-CT上具有一定特点,有助于术前诊断.