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目的探讨中枢神经系统淋巴瘤MRI的表现及诊断价值。方法回顾性分析11例中枢神经系统淋巴瘤的MR表现,评价不同MR检查方法的诊断价值。结果11例淋巴瘤均为大B细胞淋巴瘤,4例单发,7例为多发。共有结节24个,其中颞叶8个,顶叶5个,额叶4个,枕叶3个,小脑4个,2个结节灶中央出现坏死,1例伴有脑膜转移。淋巴瘤结节T1WI呈等或略长信号,T2WI以及FLAIR表现为稍高信号,坏死区T2WI以及FLAIR表现为高信号;周围脑白质均有中度水肿,在T2WI以及FLAIR显示明显;3例有轻度占位效应。淋巴瘤均呈中等强度的均匀增强,1例可见脑膜线样增强。瘤结节在DWI表现为高信号。MRS表现为NAA峰中等程度降低,Cho峰升高,Cr峰降低,并有巨大Lac/Lip复合峰出现。结论颅内深部单发或多发结节样病灶,在T1WI为等或略低信号,T2WI或FLAIR为等或稍高信号,中等强度增强,磁共振波谱呈现为巨大Lip/Lac峰,应考虑中枢神经系统淋巴瘤的诊断。
Objective To investigate the MRI manifestations and diagnostic value of central nervous system lymphoma. Methods The MR findings of 11 cases of central nervous system lymphoma were retrospectively analyzed to evaluate the diagnostic value of different MR methods. Results All the 11 cases of lymphoma were large B - cell lymphoma, 4 cases were single and 7 cases were multiple. There were 24 nodules, including 8 temporal lobes, 5 parietal lobes, 4 frontal lobes, 3 occipital lobes, 4 cerebellum, 2 central necrosis of nodules and 1 case of meningeal metastasis. Lymphoma nodules showed equal or slightly longer signal on T1WI, T2WI and FLAIR showed slightly higher signal, necrotic area T2WI and FLAIR showed high signal, moderate edema in peripheral white matter, obvious in T2WI and FLAIR, and 3 cases had Mild placeholder effect. Lymphoma were moderately uniform enhancement, a case of visible meningeal-like enhancement. Nodules in the DWI showed high signal. MRS showed a moderate decrease of NAA peak, a rise of Cho peak, a decrease of Cr peak, and a large Lac / Lip complex peak. Conclusions The intracranial deep solitary or multiple nodular lesions showed equal or slightly lower signal at T1WI, equal or slightly higher signals at T2WI or FLAIR, moderate enhancement of intensity, and magnetic resonance spectroscopy with a huge Lip / Lac peak. The central Diagnosis of nervous system lymphoma.