25例颅内原发性淋巴瘤核磁共振影像表现的回顾性研究

摘要

目的：探讨磁共振成像（MRI）对颅内原发性淋巴瘤的临床诊断价值。方法回顾性分析广东省农垦中心医院2012－01—2015－06期间接收并经手术病理确诊的25例原发性淋巴瘤患者的MRI检查资料，并对原发性淋巴瘤患者的病变大小、位置、形态等MRI影像特征、检出率及其病理特点进行综合分析。结果25例原发性淋巴瘤患者均为非霍奇金氏淋巴瘤，其中21例为单发肿瘤，3例为多发肿瘤，肿瘤位于额叶、颞叶、基底节区、丘脑、小脑半球的患者分别有8例、6例、5例、4例、2例；本组25例肿瘤的MRI信号特征如下：（1） T1 WI呈等信号14例，呈稍低信号8例，呈混杂不均匀信号3例；（2） T2 WI呈稍高信号19例，呈等信号3例，呈不均匀混杂信号3例；（3）增强扫描后，所有肿瘤中明显强化的有20例，强化不均匀有5例。出现“脐凹征”有12例，“尖角征”10例，同时出现“脐凹征”、“尖角征”有6例。21例肿瘤周围显示有水肿带。（4）同时行DWI序列扫描15例，病灶均有不同程度弥散受限，瘤体ADC值为（0．54～0．72）×10－3 mm／s，平均ADC值为（0．65±0．07）×10 mm－3／s。 MRI对本组原发性淋巴瘤肿瘤的术前诊断符合率为72．0％。结论颅内原发性淋巴瘤MRI影像表现具有一定特征性，通过综合分析其MRI影像表现特点可对大部分病灶作出准确诊断。%Objective To investigate the clinical value of MRI diagnosis of primary intracranial lymphoma.Methods Retrospectively analyzing MRI data of 25 patients with primary lymphoma proved by surgery and pathology from January, 2012 to June, 2015 in the hospital.Comprehensive analysis of lesion size, location, shape and other MRI features, detection rate and its pathological characteristicswere done.Results 25 cases of primary lymphoma patients were non Hodgkin′s lymphoma, including 21 cases of single tumor, and 3 casesof multiple tumors.Tumors located in the frontal lobe, temporal lobe, basal ganglia and thalamus, cerebellar hemisphere were 8, 6, 5,4 and 2 cases; MRI signal features of 25 cases were as follows: (1)T1 WI showed equal signal in 14 cases, showed slightly lower signal in8 cases, and showed mixed signal in 3 cases; (2)T2 WI showed slightly high signal in 19 cases, showed equal signal in 3 cases and showeduniform mixed signal in 3 cases; (3)After enhanced scan, among all tumors, 20 cases were significantly enhanced, and 5 cases were uneven.There was “notch sign” in 12 cases, “sharp” sign in 10 cases, at the same time “notch sign” and “sharp sign” in 6 cases.21 casesof tumors showed edema.(4)DWI sequence scanning was used in 15 cases.The lesions had different degrees of diffusion.The tumor ADCvalue was (0.54 ~0.72) ×10 -3 mm/s, and the average value of ADC was (0.65 ±0.07) ×10 mm-3 /s.The MRI of this group of primarylymphoma tumor preoperative diagnosis rate was 72.0%.Conclusion The findings of intracranial primary lymphoma MRI imaging havecertain characteristics.Through a comprehensive analysis of the appearances of MRI, it can make accurate diagnosis of most lesions.