Asaumi Jun-ichi, Yanagi Yoshinobu, Hisatomi Miki, Matsuzaki Hidenobu, Konouchi Hironobu, Kishi Kanji
Department of Oral and Maxillofacial Radiology, Field of Tumor Biology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8525, Japan.
Eur J Radiol. 2003 Nov;48(2):183-7. doi: 10.1016/S0720-048X(02)00347-9.
In this study, we attempted to diagnose malignant lymphoma on the basis of magnetic resonance imagings (MRIs) and dynamic contrast-enhanced MRI (DCE-MRI). Eighteen lesions (in eight patients), all of which had been proven histopathologically, were detected on MRI. The eight patients included five patients with diffuse large B-cell lymphoma, one with B-cell low-grade MALT lymphoma, one with follicular lymphoma, and one with Hodgkin's lymphoma. Nine lesions were located in the submandibular region, three in the buccal region, two in the orbit region, two in the submental region, and one each in the palatal and tonsil regions. The diameter of the lesions ranged between 9 and 42.2 mm (average: 22.4 mm). The signal intensities (SIs) of the 18 lesions were examined on T1-weighted (T1WI), T2WI, and gadopentetate (Gd)-T1WI. One lesion in case 8 was excluded from DCE-MRI findings, i.e., the regions of interest could not be adequately set on DCE-MRIs. The contrast index (CI) curves of the remaining 17 lesions were prepared. All 18 lesions showed almost the same images on T1WI, T2WI, and Gd-T1WI, although they represented four types of lymphoma. The images showed homogeneous SI that was intermediate to slightly high SI on T1WI, slightly high SI on T2WI, and moderately enhanced on Gd-T1WI. Thus, the cases of malignant lymphoma in this study showed relatively characteristic features based on MRI; however, these features might be non-specific. The CI curves in this study showed a relatively rapid increase, reaching a maximum CI at 45-120 s, and a relatively rapid decrease in most lesions (14/17; 82.4%); on the other hand, the curves of 3 of the 15 lesions (17.6%) showed relatively rapid increase, sustenance of a plateau, and a gradual decrease thereafter. These patterns of CI curves may indicate characteristic features useful for distinguishing malignant lymphomas from other lesions.
在本研究中，我们试图基于磁共振成像（MRI）和动态对比增强MRI（DCE-MRI）来诊断恶性淋巴瘤。在MRI上检测到18个病灶（8例患者），所有病灶均经组织病理学证实。8例患者包括5例弥漫性大B细胞淋巴瘤、1例B细胞低度黏膜相关淋巴组织淋巴瘤、1例滤泡性淋巴瘤和1例霍奇金淋巴瘤。9个病灶位于下颌下区，3个位于颊区，2个位于眶区，2个位于颏下区，腭区和扁桃体区各有1个。病灶直径在9至42.2mm之间（平均：22.4mm）。在T1加权（T1WI）、T2WI和钆喷酸葡胺（Gd）-T1WI上检查18个病灶的信号强度（SI）。病例8中的1个病灶被排除在DCE-MRI结果之外，即无法在DCE-MRI上充分设置感兴趣区。绘制了其余17个病灶的对比指数（CI）曲线。尽管18个病灶代表四种类型的淋巴瘤，但在T1WI、T2WI和Gd-T1WI上显示出几乎相同的图像。图像显示均匀的SI，在T1WI上为中等至略高SI，在T2WI上为略高SI，在Gd-T1WI上为中度强化。因此，本研究中的恶性淋巴瘤病例基于MRI显示出相对特征性的表现；然而，这些特征可能是非特异性的。本研究中的CI曲线显示出相对快速的上升，在45至120秒达到最大CI，并且大多数病灶（14/17；82.4%）相对快速下降；另一方面，15个病灶中的3个（17.6%）的曲线显示出相对快速的上升、平台期的维持以及随后的逐渐下降。这些CI曲线模式可能表明有助于将恶性淋巴瘤与其他病灶区分开来的特征性表现。
