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探讨和分析原发性脑B细胞性淋巴瘤MR影像特点,提高诊断的准确率。方法:将MR平扫脑内有单发肿块的71例患者,给予DWI扫描,同时分别在造影剂注射后,应用25 s、125 s和185 s三个时相进行增强扫描。根据病理资料,将所有患者分组,并测量各组ADC值、平扫时的信号强度和增强后不同时相病灶的信号强度,将所有数据进行比较分析。结果:71例中58例患者具备完整的病理资料,其中包括原发性脑B细胞性淋巴瘤12例、胶质母细胞瘤20例、肺腺癌脑转移26例。将原发性脑B细胞性淋巴瘤、胶质母细胞瘤及肺癌脑转移瘤的ADC值及平扫信号强度进行组间比较,均无统计学意义。将原发性脑B细胞性淋巴瘤三个增强时相的平均信号强度进行比较,25 s和125 s时相相关系数为1.0,有统计学差异,25 s与185 s时相及125 s与185 s时相相关系数分别为0.992、0.994,无统计学意义。原发性脑B细胞性淋巴瘤与胶质母细胞瘤有5个时相点有鉴别意义,而与肺腺癌脑转移中有11个时相点有鉴别意义。结论:应用MR多时相增强扫描,有助于鉴别原发性脑B细胞性淋巴瘤、胶质母细胞瘤及肺腺癌脑转移,而ADC值无鉴别价值。
To explore and analyze the characteristics of MR imaging of primary brain B cell lymphoma and to improve the diagnostic accuracy. Methods: Seventy-one patients with single tumor mass in the brain were scanned with DWI, and the contrast-enhanced injection was performed on three phases of 25 s, 125 s and 185 s respectively. According to the pathological data, all the patients were grouped, and the ADC value of each group was measured, the signal intensity at the time of plain scan and the signal intensity of lesions at different time after enhancement were compared, and all the data were compared and analyzed. Results: Of 71 patients, 58 patients had complete pathological data, including 12 cases of primary brain B cell lymphoma, 20 cases of glioblastoma and 26 cases of lung adenocarcinoma brain metastases. There was no significant difference between the ADC values and the signal intensity of plain scan in primary brain B cell lymphoma, glioblastoma and brain metastases of lung cancer. The mean signal intensities of the three enhanced phases of primary brain B cell lymphoma were compared. The correlation coefficient between the 25 s and the 125 s was 1.0. There was a significant difference between the 25 s and 185 s phases and the 125 s and Correlation coefficients of 185 s were 0.992,0.994, respectively, with no statistical significance. Primary brain B cell lymphoma and glioblastoma have five points of phase differential significance, but with lung adenocarcinoma brain metastasis in 11 points of phase differential significance. Conclusion: MR multiphase enhanced scan is helpful to differentiate primary brain B-cell lymphoma, glioblastoma and lung adenocarcinoma from brain metastasis, while ADC value has no distinguishing value.