White L M, Schweitzer M E, Khalili K, Howarth D J, Wunder J S, Bell R S
Department of Radiology, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
AJR Am J Roentgenol. 1998 May;170(5):1243-7. doi: 10.2214/ajr.170.5.9574594.
The purpose of this study was to investigate the MR imaging characteristics of primary lymphoma of bone.
Records of 27 patients with histologic and clinical evidence of primary lymphoma of bone were retrospectively reviewed. Nineteen of these patients underwent MR imaging before surgical biopsy and initiation of therapy. Fifteen of the 19 patients underwent conventional spin-echo T1- and T2-weighted imaging, and the other four patients underwent T1-weighted and fast spin-echo T2-weighted imaging with fat saturation. MR images were separately and independently reviewed by two observers for signal intensity characteristics and homogeneity on T1- and T2-weighted sequences. Signal intensity characteristics were correlated with semiquantitative histopathologic assessments of tumor fibrosis, maturity of fibrosis, and vascularity.
T1-weighted signal intensity ranged from isointense to hypointense relative to muscle for all lesions. Twelve of 19 cases showed heterogeneity of signal intensity on T2-weighted images. Predominant tumor T2-weighted signal intensities relative to fat for the 19 patients were assessed as hypointense (observer 1, n = 3; observer 2, n = 1), isointense (observer 1, n = 10; observer 2, n = 11), and hyperintense (observer 1, n = 6; observer 2, n = 7). No correlation among intralesional fibrosis, maturity of fibrosis, or intralesional vascularity and T2-weighted signal intensity characteristics was found.
T2-weighted MR imaging characteristics of primary lymphoma of bone vary and do not seem to be a simple reflection of histologic findings of intralesional vascularity or fibrosis.
本研究旨在探讨骨原发性淋巴瘤的磁共振成像(MR)特征。
回顾性分析27例有骨原发性淋巴瘤组织学和临床证据患者的记录。其中19例患者在手术活检和开始治疗前行MR成像。19例患者中的15例进行了常规自旋回波T1加权和T2加权成像,另外4例患者进行了脂肪抑制T1加权和快速自旋回波T2加权成像。两名观察者分别独立地对MR图像进行T1加权和T2加权序列的信号强度特征及均匀性评估。信号强度特征与肿瘤纤维化、纤维化成熟度及血管分布的半定量组织病理学评估相关。
所有病变在T1加权像上的信号强度相对于肌肉从等信号到低信号不等。19例中有12例在T2加权像上表现为信号强度不均匀。19例患者肿瘤在T2加权像上相对于脂肪的主要信号强度评估为低信号(观察者1,3例;观察者2,1例)、等信号(观察者1,10例;观察者2,11例)和高信号(观察者1,6例;观察者2,7例)。未发现瘤内纤维化、纤维化成熟度或瘤内血管分布与T2加权信号强度特征之间存在相关性。
骨原发性淋巴瘤的T2加权MR成像特征各异,似乎并非瘤内血管或纤维化组织学表现的简单反映。