Zhang Wei-Dong, Wu Pei-Hong, Xie Chuan-Miao, Li Hui
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
Ai Zheng. 2007 Jul;26(7):775-7.
BACKGROUND & OBJECTIVE: Primary brain lymphoma, a rare tumor, is often misdiagnosed as malignant glioma or metastases before operation. A definite preoperative diagnosis of primary brain lymphoma is of great significance because of its sensitive to chemotherapy and irradiation. This study was to analyze the magnetic resonance imaging (MRI) features of primary brain lymphoma to improve the diagnosis and differential diagnosis accuracy.
MRI findings in 9 patients with pathologically proved primary brain lymphoma were analyzed for the number of lesions, tumor site, signal intensity, peritumoral edema, mass effect and contrast enhancement patterns.
Of the 9 patients, 8 had supratentorial solitary lesion, and 1 had supratentorial and infratentorial solitary lesion. On plain MRI, 8 lesions were hypo-intense and 1 iso-intense on T1WI, while 6 displayed iso-intense, 1 hypo-intense and 2 slightly hyper-intense on T2WI. Necrosis was seen in 2 lesions. The peritumoral edema was mild in 5 lesions, moderate in 3 lesions, and severe in 1 lesion. On Gd-DTPA-enhanced MRI, 4 lesions displayed obvious homogeneous mass-like enhancement, 3 lobular enhancement and 2 ring-like enhancement.
Primary brain lymphoma in immunocompetent patients has typical MRI features. Correct diagnosis could be made before operation when imaging findings are considered together with clinical data.
原发性脑淋巴瘤是一种罕见肿瘤,术前常被误诊为恶性胶质瘤或转移瘤。由于其对化疗和放疗敏感,术前明确诊断原发性脑淋巴瘤具有重要意义。本研究旨在分析原发性脑淋巴瘤的磁共振成像(MRI)特征,以提高诊断及鉴别诊断的准确性。
分析9例经病理证实的原发性脑淋巴瘤患者的MRI表现,包括病灶数量、肿瘤部位、信号强度、瘤周水肿、占位效应及对比增强方式。
9例患者中,8例幕上有孤立病灶,1例幕上和幕下有孤立病灶。MRI平扫时,8个病灶在T1WI上呈低信号,1个呈等信号;在T2WI上,6个呈等信号,1个呈低信号,2个呈轻度高信号。2个病灶可见坏死。5个病灶瘤周水肿轻度,3个中度,1个重度。Gd-DTPA增强MRI检查时,4个病灶呈明显均匀团块状强化,3个呈小叶状强化,2个呈环形强化。
免疫功能正常患者的原发性脑淋巴瘤具有典型的MRI特征。结合影像学表现与临床资料,术前可做出正确诊断。