磁共振波谱及扩散加权成像在中枢神经系统淋巴瘤诊断中的效果

摘要

目的：研究磁共振波谱（MRS）和扩散加权成像（DWI）在中枢神经系统淋巴瘤（PCNSL）临床诊断中的应用价值。方法选取2010年1月至2015年11月经过临床诊断确诊为PCNSL的患者24例，回顾性分析MRS和DWI的诊断资料，分析两者在PCNSL中的诊断价值。结果24例PCNSL患者共检测出32个病灶；MRS检测氮－乙酰天门冬氨酸（NAA）峰降低，胆碱（Cho）峰升高，肌酸（Cr）峰降低，脂质峰和乳酸峰的存在达到90．6％（29／32）。DWI诊断高倍信号约占87．5％（21／24），12．5％的混杂信号，瘤体实质区域ADC的值为（0．60±0．08）mm2／s，与病理学检测的一致性高达95．8％。结论 DWI和MRS在对PCNSL进行诊断时，都具有自己独特的特点，MRS诊断图谱显示NAA 峰降低，Cho峰升高，Cr峰降低，大部分存在脂质峰和乳酸峰， DWI因弥散受限，造成ADC降低的特点，这些诊断结果的特征有利于磁共振对于PCNSL的诊断。%Objective To study the diagnostic value of magnetic resonance spectroscopy (spectroscopic MRS,MR)and imaging DWI (dif usion-weighted)in the diagnosis of central nervous system lymphoma (PCNSL). Methods 24 cases were selected from January 2010 to August 2014. The diag-nostic value of PCNSL and MRS were retrospectively analyzed. Results 24 cases of PC NSL patients were detected with 32 lesions. MRS detected NAA peak, Cho peak,Cr peak decreased,lipid peak and lactate peak reached 90. 6%(29/32);DWI diagnostic value was 87. 5% (21/24),12. 5%,The value of ADC was (0. 60 ±0. 08)mm2/s,and the consistency of the pathologic examination was as high as 95. 8%. Conclusion MRS and MRS in the diagnosis of central nervous system lymphoma. The peak of NAA was decreased,the peak of Cr was increased,and the Cho peak was lower,and most of them had lipid peak and lactate peak. DWI was characterized by dif usion limitation,which resulted in ADC decrease.