Nakazawa T, Matsuda M, Nakasu S, Hanada J, Koyama T
Department of Neurosurgery, Shiga University of Medical Science.
Nihon Geka Hokan. 1990 Mar 1;59(2):141-7.
Radiological features of 12 cases of primary malignant lymphoma of the central nervous system with histological confirmation were reviewed. Ten patients had primary intracranial lymphoma, and two spinal. Angiography yielded no specific findings. CT appearances varied widely. Any positive relationships were not found between histologic types of tumors and patterns of contrast enhancement in the present cases as well as in those reported previously. Gd-DTPA was used in two patients. All lymphomas showed low to isointensity signals on T1-WI and high signal intensities on rho-WI and T2-WI. Although MRI gave no additional informations to those on CT with regard to the differential diagnosis, it proved to be a very accurate, non-invasive method of providing better delineation of tumor on multiplanar basis. Use of Gd-DTPA improved quality of T1-WI by markedly enhancing the tumor. It is generally difficult to distinguish primary from secondary spinal lymphoma, but two spinal epidural lymphomas in the present series were considered primary, as we could detect no other lesion elsewhere in the body. We expect that MR imaging would lead to an improvement in the detection of lesion in the paravertebral area.
回顾了12例经组织学证实的原发性中枢神经系统恶性淋巴瘤的放射学特征。10例患者为原发性颅内淋巴瘤，2例为脊髓淋巴瘤。血管造影未发现特异性表现。CT表现差异很大。在本病例以及先前报道的病例中，未发现肿瘤组织学类型与对比增强模式之间存在任何正相关关系。2例患者使用了钆喷酸葡胺（Gd-DTPA）。所有淋巴瘤在T1加权像（T1-WI）上呈低至等信号，在质子加权像（rho-WI）和T2加权像（T2-WI）上呈高信号。尽管在鉴别诊断方面，磁共振成像（MRI）相较于CT未提供更多信息，但它被证明是一种非常准确的非侵入性方法，能够在多平面基础上更好地描绘肿瘤。使用Gd-DTPA通过显著增强肿瘤来提高T1-WI的质量。原发性脊髓淋巴瘤与继发性脊髓淋巴瘤通常难以区分，但本系列中的2例脊髓硬膜外淋巴瘤被认为是原发性的，因为我们在身体其他部位未发现其他病变。我们期望磁共振成像能够提高椎旁区域病变的检出率。
