| 耿磊,孙毅,汪秀玲,徐凯.常规MRI及DWI诊断非典型性原发性中枢神经系统淋巴瘤[J].中国医学影像技术,2018,34(10):1455~1459 |
| 常规MRI及DWI诊断非典型性原发性中枢神经系统淋巴瘤 |
| Conventional MRI and DWI in diagnosis of atypical primary central nervous system lymphoma |
| 投稿时间：2018-02-25 修订日期：2018-07-04 |
| DOI：10.13929/j.1003-3289.201802106 |
| 中文关键词: 淋巴瘤 中枢神经系统 磁共振成像 表观扩散系数 |
| 英文关键词:Lymphoma Central nervous system Magnetic resonance imaging Apparent diffusion coefficient |
| 基金项目:连云港市卫生局科研课题计划（1318）。 |
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| 中文摘要: |
| 目的 探讨常规MRI联合DWI诊断非典型性原发性中枢神经系统淋巴瘤（PCNSL）的价值。方法 分析14例经病理证实的非典型性PCNSL患者的常规MRI及DWI特征，测量肿瘤实质区、瘤周近侧水肿区、瘤周远侧水肿区、对侧正常脑白质区的ADC值，并计算相对ADC（rADC）值，比较不同区域ADC值和rADC值的差异。结果 14例PCNSL中，单发12例，多发2例，共20个病灶，其中9个病灶位于非常规好发部位，包括脑浅表部位5个，脑干脑桥区、小脑半球、鞍区和第三脑室各1个。非典型性PCNSL的MRI表现包括3个病灶出现囊变、坏死区，1个病灶可见内部出血，7个病灶呈环形强化，3个病灶呈不规则片状强化。肿瘤实质区的ADC值为（0.70±0.15）×10-3mm2/s，rADC值为0.86±0.14，均低于瘤周近侧和远侧水肿区（P均<0.05），瘤周近侧水肿区ADC值高于远侧瘤周水肿区（P<0.05）。结论 对比常规MRI及DWI中肿瘤实质区、瘤周近侧水肿区、瘤周远侧水肿区的ADC、rADC值的差异，有助于诊断和鉴别诊断PCNSL。 |
| 英文摘要: |
| Objective To explore the value of conventional MRI and DWI in diagnosis of atypical primary central nervous system lymphoma (PCNSL). Methods Routine MRI and DWI features of 14 patients with atypical PCNSL confirmed by pathology were analyzed. ADC value of tumor nature, proximal peritumor edema area, distal peritumor edema area and the contralateral normal white matter area were measured, and the relative ADC (rADC) value was calculated. The differences of ADC and rADC value were compared among different regions of PCNSL. Results In all 14 patients, 12 had single and 2 had multiple PCNSL lesions. Nine lesions located in atypical regions, including 5 in cerebral superficial regions, each 1 in the brainstem and pon, cerebellum, sellar and the third ventricle. The atypical MRI manifestations included cystic necrosis in 3 lesions, internal hemorrhage in 1 lesion, circular enhancement in 7 lesions and irregular laminar enhancement in 3 lesions. ADC value of tumor parenchyma was (0.70±0.15)×10-3 mm2/s, and rADC value was 0.86±0.14, both lower than those of the proximal and distal peritumor edema regions (all P<0.05), while ADC value of the proximal peritumor edema region was higher than that of distal peritumor edema region (P<0.05). Conclusion Comparison of ADC and rADC value in tumor parenchyma, proximal and distal peritumoral edema regions is helpful to diagnosis and differential diagnosis of PCNSL. |
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