[1]卢善良,陈玉珊,林景恋,等.MRI在原发性中枢神经系统淋巴瘤与脱髓鞘假瘤鉴别中的价值[J].福建医药杂志,2024,46(04):1-5.[doi:10.20148/j.fmj.2024.04.001]
　LU Shanliang,CHEN Yushan,LIN Jinglian,et al.Significance of MRI in the differential diagnosis of primary central nervous system lymphoma and demyelinafing pseudotumors of brain[J].FUJIAN MEDICAL JOURNAL,2024,46(04):1-5.[doi:10.20148/j.fmj.2024.04.001]
点击复制

MRI在原发性中枢神经系统淋巴瘤与脱髓鞘假瘤鉴别中的价值()
分享到：

《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
46
期数:
2024年04期
页码:
1-5
栏目:
临床研究
出版日期:
2024-08-15

文章信息/Info

Title:
Significance of MRI in the differential diagnosis of primary central nervous system lymphoma and demyelinafing pseudotumors of brain
文章编号:
1002-2600(2024)04-0001-05
作者:
卢善良; 陈玉珊; 林景恋; 詹淑君
福建医科大学附属漳州市医院影像科,漳州 363000
Author(s):
LU Shanliang; CHEN Yushan; LIN Jinglian; ZHAN Shujun
Department of Imaging,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou,Fujian 363000,China
关键词:
磁共振成像;  中枢神经系统;  脱髓鞘假瘤;  淋巴瘤;  鉴别诊断
Keywords:
magnetic resonance imaging(MRI);  central nervous system;  demyelinating pseudotumor;  lymphoma;  differential diagnosis
分类号:
R733.4; R445.2
DOI:
10.20148/j.fmj.2024.04.001
文献标志码:
B
摘要:
目的 探讨原发性中枢神经系统淋巴瘤(PCNSL)与脱髓鞘假瘤(DPTs)磁共振(MRI)的影像表现,提高两组疾病诊断准确性。方法 回顾性分析41例中枢神经系统淋巴瘤和30例脱髓鞘假瘤的MRI检查,并分析两组MRI的影像学特征。结果 PCNSL组与DPTs组在年龄、性别和临床症状上的差异无统计学意义(P>0.05),在病灶最大径、弥散加权成像(diffusion weighted imaging,DWI)、表观扩散系数(appearance diffusion coefficient,ADC)、磁敏感加权成像(magnetic susceptibility-weighted imaging,SWI)上存在统计学差异(P<0.05); PCNSL增强扫描呈明显均匀强化,部分病灶出现典型“缺口征”、“尖角征”,磁共振波谱分析(magnetic resonance spectroscopy,MRS)出现凋亡相关宽大Lip峰,可见Lac峰; DPTs增强扫描呈边缘环形轻度强化或无强化,MRS无特异性。结论 PCNSL组的弥散受限、SWI信号减低发生率高于DPTs患者,结合增强扫描和MRS,可提高诊断准确性。
Abstract:
Objective To investigate the imaging findings of magnetic resonance imaging(MRI)in the diagnosis of demyelinating pseudotumor and lymphoma of central nervous system,and to improve the correct diagnosis rate of the disease. Methods A retrospective analysis of 41 patients with central nervous system lymphoma and 30 patients with demyelinating pseudotumor was carried out. MRI was performed on these patients and the imaging features were summarized. Results There was no statistically significant difference in age,sex,and clinical symptoms(P>0.05). The MRI findings that showed statistical significance between the two groups included the maximum diameter,diffusion weighted imaging(DWI)combined with apparent diffusion coefficient(ADC), sensitive weighted imaging(SWI). Primary central nervous system lymphoma: MRI imaging features showed uniform enhancement characteristics after scan enhancement, manifested as “incision” and “angular”. And MRS showed highly elevated lipid peak and inverted lactic acid peak. Demyelinating pseudotumors: The lesions had round or no enhancement on MRI scan. And MRS showed no specificity. Conclusion The PCNSL group had a higher incidence of diffusion-limited and reducing SWI signal than patients with DPTs, which is of great value in improving the diagnostic accuracy of PCNSL and DPTs. Enhanced scanning and MRS also have diagnostic value in the two groups.

参考文献/References:

[1] 李盼盼,张卓.原发性中枢神经系统淋巴瘤的放射治疗进展[J].中华放射肿瘤学杂志,2022,31(5):473-477.
[2] 花奕,张卫琴,沈珏,等. 髓鞘少突胶质细胞糖蛋白抗体阳性的儿童中枢神经系统脱髓鞘疾病临床特点[J].中华实用儿科临床杂志,2020,35(6):450-453.
[3] 程静,刘兴旺,赵静,等.常见中枢神经系统脱髓鞘疾病诊断中磁共振成像的价值及其有效性分析[J].影像研究与医学应用,2020,4(15):43-44.
[4] 史延斌,曾莹婷,李逸攀,等.原发性中枢神经系统淋巴瘤在免疫功能正常或低下患者的 MRI成像特征[J].新发传染病电子杂志,2023,8(2):39-44.
[5] CHENG G,ZHANG J. Imaging features(CT,MRI,MRS,and PET/CT)of primary central nervous system lymphoma in immunocompetent patients[J].Neurol Sci,2019,40: 535-542.
[6] 刘欣蔚,王健红,吴振天,等.高危原发中枢神经系统淋巴瘤1例[J].中国临床案例成果数据库,2024,6(1):E0210-E0210.
[7] 靳欣,李凯悦,周雨菁,等.原发性中枢神经系统T细胞淋巴瘤1例并文献复习[J],白血病·淋巴瘤,2023,32(12):754-756.
[8] LÖW S,HAN C H,Batchelor TT. Primary central nervous system lymphoma[J].Ther Adv Neurol Disord,2018,11:1756286418793562.
[9] GROMMES C,DEANGELIS L M. Primary CNS lymphoma[J].J Clin Oncol,2017,35(21):24102418.
[10] GANDHI M K,HOANG T,LAW S C,et al. EBV - associated primary CNS lymphoma occurring after immunosuppression is a distinct immunobiological entity[J].Blood,2021,137(11):1468-1477.
[11] 李扬,任静,闫春伟,等.免疫功能正常原发性中枢神经系统淋巴瘤的MRI误诊分析[J].临床误诊误治,2023,36(6):28-31.
[12] 梁新悦,闫玉蓉,黄文荣,等.初治原发性中枢神经系统淋巴瘤临床特征及预后的多中心、回顾性研究[J].白血病·淋巴瘤,2023,32(8):465-472.
[13] TANG D,CHEN Y,SHI Y,et al. Epidemiologic characteristics,prognostic factors, and treatment outcomes in primary centralnervous system lymphoma:a SEER -based study[J].Front Oncol,2022,12:817043.
[14] 赵晖,李虓,宋蓓,等.脑脊液实验室检测在原发性中枢神经系统淋巴瘤诊断中的价值探讨[J].中华检验医学杂志,2021,44(1):55-60.
[15] 赵雪. CT与MRI 在中枢神经系统脱髓鞘假瘤与淋巴瘤诊断中的价值分析[J].中国实用医药,2022,17(13):58-60.
[16] 白洁,刘玥,张宁宁,等.中枢神经肿瘤样脱髓鞘病2例[J].中国临床案例成果数据库,2022,4(1):103-105.
[17] 王瑞举,张庆彦,刘荣成,等.DWI联合ADC值在胃癌分化程度评估中的应用[J].中国实用医刊,2021,48(23):79-82.
[18] HE Y X,QU C X,HE Y Y,et al. Conventional MR and DW imaging findings of cerebellar primary CNS lymphoma: comparison with high-grade glioma[J].Sci Rep,2020,10(1):10007.
[19] 王微微,牛田力,苗延巍,等.SWI对星形细胞瘤分级及与单发转移瘤鉴别诊断的价值[J].磁共振成像,2015,6(4):246-252.
[20] 孙珊珊,林勇,曹棉富,等.影像及病理形态酷似胶质瘤的脱髓鞘病变1例[J].中国临床案例成果数据库,2023,05(1):e00528-e00528.
[21] 李扬,刘福生,刘元波,等.原发性中枢神经系统淋巴瘤的诊断与治疗[J].中华血液学杂志,2014,35(5):771-773.
[22] 靳欣,李凯悦,周雨菁,等.原发性中枢神经系统淋巴瘤的影像学研究进展[J].国际放射医学核医学杂志,2022,46(11):679-684.
[23] 李红军,朱荣广.MRI和 CT在中枢神经系统淋巴瘤诊断中的应用价值[J].中国实用医刊,2013,40(19):44-46.

相似文献/References:

[1]林圣美,程章波,张玮,等.T1 SPACE技术诊断Cockett综合征的临床应用价值[J].福建医药杂志,2022,44(04):1.
　LIN Shengmei,CHENG Zhangbo,ZHANG wei,et al.Clinical value of T1 SPACE technique in the diagnosis of Cockett syndrome[J].FUJIAN MEDICAL JOURNAL,2022,44(04):1.

备注/Memo

备注/Memo:
基金项目:2021年福建省自然科学基金面上项目(2021J011409)
通信作者:陈玉珊,Email: cys6899@163.com
更新日期/Last Update: 2024-08-15