原发性中枢神经系统恶性淋巴瘤MR表现研究.doc

原发性中枢神经系统恶性淋巴瘤MR表现研究 [摘要] 目的 探讨原发性中枢神经系统恶性淋巴瘤(PCNSML)临床与影像学表现特点,提高本病的影像诊断水平。方法 收集经手术、病理和免疫组化证实,资料齐全的颅内恶性非霍杰金淋巴瘤18例,回顾性分析其临床和MR表现。结果 临床主要症状为头痛、恶心、偏瘫、肢体麻痹、视觉障碍等。18例患者单发肿瘤13例,多发肿瘤5例,肿瘤常常位于脑表面或近中线部位,T1WI呈略低或等信号,T2WI 为低、等或略高信号,增强扫描病灶为明显均匀或不均匀强化,多呈“类圆形”或“团块状”。所有病灶都有占位效应,水肿程度不一。结论 原发性中枢神经系统恶性淋巴瘤影像表现多样,但具有一定特征,MR扫描有助于该病变的诊断。 [关键词] 颅内肿瘤; 恶性淋巴瘤; 磁共振成像 [中图分类号] R733 [文献标识码] A [文章编号] 1673-9701(2010)09-50-02 MRI Analysis of Primary Central Nervous System M alignant Lymphoma GUAN Zejing1 SU Jinquan2 ZHOU Yongsheng2 1.Disease Prevention and Control Center of Baoan Zone,Shenzhen 518101,China;2.Departmentof Radiology,the Affiliated Shenzhen Baoan Hospital of Southern Medical University,Shenzhen 518101,China [Abstract] ObjectiveTo explore the appearances of CT and MR with primary intracranial m alignant lymphoma,in order to heighten the level of image diagnostics. MethodsThe clinical manifestations and findings of CT and MR1 were analyzedretrospectively in 18 patients with primary intracranial m alignant non-Hodgkin lymphoma proved by surgery,pathology and immunohistochemistry. ResultsThe chief clinical manifestations were headache,nausea,hemiparesis,cerebellar signs,cranial nerve palsies,and visual disturbances. Most lesions were located near the surface or middle line of cerebrum. Slightly hypointense or isointense on T1WI,and sligtly hypointense or isointnse or slightly hyperintense on T2WI,and homogeneous or inhomogeneous Gd-DTPA enhancement presented in most of the tumors,like“round”or“clump”. Mass effect and various edema surrounding the lesion can be seen in all the cases. ConclusionPrimary intracranial m alignant lymphoma has various imaging appearances,and there are the characteristic features. MR are helpful in diagnosis which can provide important information for therapeutic planning. [Key words]Intracranial neoplasm; M alignant lymphoma; Magnetic resonance imaging 原发性中枢神经系统淋巴瘤(PCNSML)是少见的恶性肿瘤,是起源于神经系统的结外非霍奇金淋巴瘤,主要累及大脑、眼玻璃体、神经、脑脊膜、颅神经和脊神经根。其病变表现多种多