颅脑恶性淋巴瘤的MRI诊断

MRI Diagnosis of Malignant Lymphomas in Craniocerebrum

  • 摘要: 总结颅脑恶性淋巴瘤的MRI表现形式和特征。方法:14例颅脑恶性淋巴瘤,分为脑实质、颅神经和颅骨三型。结果:脑实质型9例(64%)中7例多发(78%),2例单发(22%)。T1WI较低或中等信号,T2WI略高或较高信号,强化形式和形态多种多样。经随机化处理,对原发性和继发性恶性淋巴瘤诊断的正确率分别为22%,33%和22%。颅神经型3例(21%),以颅神经增粗为特征,三叉神经受累机率最高;T1WI中等信号,T2WI略高信号,强化明显且均匀。颅骨型2例(15%),颅骨破坏伴颅骨双侧或一侧软组织肿块。T1WI中等略低信号,T2WI中等或中等略高信号,强化形式多样。结论:颅脑原发性和继发性恶性淋巴瘤,均可累及多个部位,以肿瘤形态和强化的多样性为特征,MRI对于脑实质型和颅神经型诊断特异性较高,对于原发和继发定性的鉴别意义不大。

     

    Abstract: Objective : To summarize M R findings and characteristics of malignant lymphomas in craniocerebrum. Methods : There were 14 cases of malignant lymphomas in head. Three types were classified as 1) intracerebral type, 2) intracranial nerves type and 3) skull type. Results : In the first type, there are 9 cases (64%). Seven cases (78%) have multiple nidi, while 2 cases(22%) have solitary nidi. The nidi appeared slightly low or isointensity on T1WI and slightly high or high signal on T2WI.After contrast, the enhanced features were miscellaneous. The 9 cases were sorted in randomization.The diagnostic accuracy was 22%, 33% and 22% individually, based on primary and secondary origins.In the second type, there were 3 cases (21%), which specialized in thickening oi intracranial nerve or nerves. The trigeminal nerve was apt to be affected. The thicken nerves showed isointensity on T1WI and slightly high signal on T2WI. The enhancement is markedly and homogeneously. In the third type,there were 2 cases (15% ) . The skull destruction was manifest, accompanied by soft mass which surrounded the affected skull or in a side of it . The lesion showed slightly low signal on T1WI, and medium or high signal on T2WI. After the contrast, the pattern of enhancement was complicated. Conclusion : The primary and secondary lymphomas in craniocerebrum specialized in multiple lesions and miscellaneous in their shapes and types of enhancement, M R examination has more specialty in 1)intracerebral type, 2) intracranial nerves type, but there are not much significance in differential primary lymphomas from secondary lymphomas.

     

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