Department of Radiology, Shanxi Provincial People's Hospital, Affiliated People's Hospital of Shanxi Medical University, Taiyuan, 030012, China.
Department of Pathology, Shanxi Provincial People's Hospital, Affiliated People's Hospital of Shanxi Medical University, Taiyuan, 030012, China.
Sci Rep. 2020 Jun 19;10(1):10007. doi: 10.1038/s41598-020-67080-9.
Primary central nervous system lymphomas (PCNSLs) and high-grade gliomas (HGGs) arising in the cerebellum is extremely low, making the differential diagnosis difficult or even impossible. The purpose of this study was to define the MR features of cerebellar PCNSL in immunocompetent patients, and to determine whether a combination of conventional MR and DW imaging can assist in the differentiation of PCNSLs and HGGs. Twelve PCNSLs and 15 HGGs confirmed by pathological analysis were retrospectively identified. The apparent diffusion coefficient (ADC) and conventional MRI parameters were compared for differences between PCNSL and HGG groups using the independent sample t test or chi-square test. Both ADC and ADC values were lower in the PCNSL group than those in the HGG group (ADC: 0.53 × 10 vs. 0.83 × 10 mm/sec, P < 0.001; ADC: 0.66 × 10 vs. 0.98 × 10 mm/sec, P = 0.001). As for conventional MR features, there were significant difference in the tumor size, enhancement patterns, the presence of cystic changes, edema degree and streak-like edema (all P < 0.01); but there were no significant difference in lesion type, the presence of bleeding, and involvement of brain surface between two groups (P = 0.554, 0.657 and 0.157, respectively). The results revealed that several conventional MR features, including enhancement patterns, branch-like enhancement and streak-like edema may be useful for the differentiation of PCNSL and HGG in cerebellum and, when combined with ADC values, further improve the discriminating ability.
原发性中枢神经系统淋巴瘤（PCNSL）和小脑高级别胶质瘤（HGG）极为罕见，这使得鉴别诊断变得困难甚至不可能。本研究旨在明确免疫功能正常患者小脑 PCNSL 的磁共振（MR）特征，并确定常规 MR 与弥散加权成像（DWI）的联合应用是否有助于鉴别 PCNSL 和 HGG。回顾性分析经病理证实的 12 例 PCNSL 和 15 例 HGG。采用独立样本 t 检验或卡方检验比较 PCNSL 组与 HGG 组之间 ADC 值和常规 MRI 参数的差异。PCNSL 组的 ADC 值和 ADC 值均低于 HGG 组（ADC：0.53×10-3mm2/s 比 0.83×10-3mm2/s，P<0.001；ADC：0.66×10-3mm2/s 比 0.98×10-3mm2/s，P=0.001）。在常规 MR 特征方面，肿瘤大小、强化模式、囊性变、水肿程度和线状水肿存在显著差异（均 P<0.01）；但两组间病变类型、出血及脑表面受累差异无统计学意义（P=0.554、0.657 和 0.157）。结果表明，多种常规 MR 特征，包括强化模式、分支样强化和线状水肿，有助于鉴别小脑 PCNSL 和 HGG，与 ADC 值联合应用可进一步提高鉴别诊断能力。
