MRI在原发性中枢神经系统淋巴瘤与脱髓鞘假瘤鉴别中的价值
Significance of MRI in the differential diagnosis of primary central nervous system lymphoma and demyelinafing pseudotumors of brain
卢善良 1陈玉珊 1林景恋 1詹淑君1
作者信息
- 1. 福建医科大学附属漳州市医院影像科,漳州 363000
- 折叠
摘要
目的 探讨原发性中枢神经系统淋巴瘤(PCNSL)与脱髓鞘假瘤(DPTs)磁共振(MRI)的影像表现,提高两组疾病诊断准确性.方法 回顾性分析41例中枢神经系统淋巴瘤和30例脱髓鞘假瘤的MRI检查,并分析两组MRI的影像学特征.结果 PCNSL组与DPTs组在年龄、性别和临床症状上的差异无统计学意义(P＞0.05),在病灶最大径、弥散加权成像(diffusion weighted imaging,DWI)、表观扩散系数(appearance diffusion coefficient,ADC)、磁敏感加权成像(magnetic susceptibility-weighted imaging,SWI)上存在统计学差异(P＜0.05);PCNSL增强扫描呈明显均匀强化,部分病灶出现典型"缺口征"、"尖角征",磁共振波谱分析(magnetic resonance spectroscopy,MRS)出现凋亡相关宽大Lip峰,可见Lac峰;DPTs增强扫描呈边缘环形轻度强化或无强化,MRS无特异性.结论 PCNSL组的弥散受限、SWI信号减低发生率高于DPTs患者,结合增强扫描和MRS,可提高诊断准确性.
Abstract
Objective To investigate the imaging findings of magnetic resonance imaging(MRI)in the diagnosis of de-myelinating pseudotumor and lymphoma of central nervous system,and to improve the correct diagnosis rate of the disease.Methods A retrospective analysis of 41 patients with central nervous system lymphoma and 30 patients with demyelinating pseudotumor was carried out.MRI was performed on these patients and the imaging features were summarized.Results There was no statistically significant difference in age,sex,and clinical symptoms(P＞0.05).The MRI findings that showed statis-tical significance between the two groups included the maximum diameter,diffusion weighted imaging(DWI)combined with apparent diffusion coefficient(ADC),sensitive weighted imaging(SWI).Primary central nervous system lymphoma:MRI im-aging features showed uniform enhancement characteristics after scan enhancement,manifested as"incision"and"angular".And MRS showed highly elevated lipid peak and inverted lactic acid peak.Demyelinating pseudotumors:The lesions had round or no enhancement on MRI scan.And MRS showed no specificity.Conclusion The PCNSL group had a higher incidence of dif-fusion-limited and reducing SWI signal than patients with DPTs,which is of great value in improving the diagnostic accuracy of PCNSL and DPTs.Enhanced scanning and MRS also have diagnostic value in the two groups.
关键词
磁共振成像/中枢神经系统/脱髓鞘假瘤/淋巴瘤/鉴别诊断Key words
magnetic resonance imaging(MRI)/central nervous system/demyelinating pseudotumor/lymphoma/differ-ential diagnosis引用本文复制引用
基金项目
2021年福建省自然科学基金面上项目(2021J011409)
出版年
2024
NETL
NSTL
万方数据