原发性脑淋巴瘤MRI影像表现及鉴别诊断.doc

原发性脑淋巴瘤MRI影像表现及鉴别诊断 　　【摘要】 目的：探讨原发性脑淋巴瘤的MRI影像表现及鉴别诊断。方法：选择笔者所在医院2015年1-12月收治的20例原发性脑淋巴瘤患者，所有患者都采取MRI平扫以及增强扫描。对患者的MRI影像特征进行分析。结果：在20例患者中，单发14例，占70.0%，多发6例，占30.0%。22个病灶中，主要呈现卵圆形或者圆形，部分病灶为不规则形或蝶形。12个病灶的边界清晰但不锐利，8个病灶的边界模糊。患者的T1WI为均匀、非均匀等或者稍低的信号，在T2WI上大部分病灶呈等或者稍高的信号，少数病灶表现为高信号。患者病灶均出现不同程度的水肿情况，轻度5例（25.0%），中度11例（55.0%），重度4例（20.0%）。静脉注射增强之后，患者均出现了显著强化，其中15例病灶出现了明显团块状强化。DWI的表现中，4例患者病灶呈高信号。结论：原发性脑淋巴瘤的MRI具有其相应的影像特点，诊断过程需要密切注意其影像特征，并与其他相似肿瘤进行鉴别诊断，提高患者的诊断准确率，为患者治疗提供及时的治疗方案 【关键词】 原发性脑淋巴瘤； MRI影像表?F； 鉴别 doi：10.14033/j.cnki.cfmr.2016.35.031 文献标识码 B 文章编号 1674-6805（2016）35-0062-02 【Abstract】 Objective：To investigate the MRI features and differential diagnosis for patients with primary brain lymphoma.Method：From January 2015 to December 2015，20 cases with primary brain lymphoma were selected in our hospital.All patients taken plain and enhanced MRI scan.MRI imaging features of patients were analyzed.Result：In 20 patients，14 cases were single，accounting for 70.0% and 6 cases were multiple，accounting for 30.0%.In 22 lesions，mainly characterized by oval or circular，some lesions or irregular-shaped butterfly.12 lesions clear boundary，but not sharp，eight lesions fuzzy boundaries，which were uniform in T1WI，inhomogeneous signal，etc，or slightly lower，most lesions on T2WI showed equal or slightly higher signal，a small number of lesions showed high signal.There were different degrees of edema in patients with mild in 5 cases（25.0%），moderate in 11 cases（55.0%），sever in 4 cases（20.0%）.After intravenous injection enhancement，patients experienced a significant strengthening，including 15 lesions appeared obvious bolus enhancement.After DWI performance，lesions in 4 cases showed high signal.Conclusion：MRI imaging of primary brain lymphoma has its corresponding features while diagnostic procedures required close attention to its image，and doctors should make the differential diagnosis with other similar tumors.Through these efforts，it can improve the diagnostic accuracy of patients primary with