CAJ | 학술논문

目的：探讨磁共振波谱（MRS）与扩散加权成像（DWI）诊断原发性中枢神经系统淋巴瘤的临床应用价值。方法将本院收治的18例原发性中枢神经系统淋巴瘤患者作为研究对象，采用MRS、DWI、磁共振成像（MRI）扫描、增强扫描进行检查，通过对原发性中枢神经系统淋巴瘤MRI及强化图像特征的分析，评价各感兴趣区胆碱复合物（Cho）/肌酸（Cr）、N-乙酰天门冬氨酸（NAA）/Cho、NAA/Cr、脂质（Lip）/Cr、表观扩散系数（ADC）的差异。结果病变呈现等长或略长T1、T2信号， GD-DTPA增强扫描显示15例患者病灶呈均匀性明显强化，3例呈现不均匀强化。淋巴瘤实质区Lip/Cr、Cho/Cr、Cho/NAA值明显高于瘤周水肿区（P＜0.01）；瘤周水肿区Cho/Cr、Cho/NAA值明显高于健侧对照区（P＜0.01）。ADC值在肿瘤实质区、瘤周水肿区及健侧对照区呈递减趋势。结论 MRS和DWI可以明确显示原发性中枢神经系统淋巴瘤的病理变化，是临床应用价值很高的诊断技术。
목적：탐토자공진파보（MRS）여확산가권성상（DWI）진단원발성중추신경계통림파류적림상응용개치。방법장본원수치적18례원발성중추신경계통림파류환자작위연구대상，채용MRS、DWI、자공진성상（MRI）소묘、증강소묘진행검사，통과대원발성중추신경계통림파류MRI급강화도상특정적분석，평개각감흥취구담감복합물（Cho）/기산（Cr）、N-을선천문동안산（NAA）/Cho、NAA/Cr、지질（Lip）/Cr、표관확산계수（ADC）적차이。결과병변정현등장혹략장T1、T2신호， GD-DTPA증강소묘현시15례환자병조정균균성명현강화，3례정현불균균강화。림파류실질구Lip/Cr、Cho/Cr、Cho/NAA치명현고우류주수종구（P＜0.01）；류주수종구Cho/Cr、Cho/NAA치명현고우건측대조구（P＜0.01）。ADC치재종류실질구、류주수종구급건측대조구정체감추세。결론 MRS화DWI가이명학현시원발성중추신경계통림파류적병리변화，시림상응용개치흔고적진단기술。
ObjectiveTo investigate the clinical value of MRS and DWI in the diagnosis of primary central nervous system lymphoma.Method18 patients who got medical treatment in our hospital were collected as research subjects, all of them were checked with MRS, DWI, MRI scan and enhanced scan, evaluated the value of ADC, Cho/Cr, NAA/Cho, NAA/Cr and Lip/Cr under different scan ways.ResultLesions showed equaling or slightly longer T1 or T2 signal. GD-DTPA enhanced scan showed 15 lesions were enhanced homogeneous signiifcantly, 3 lesions were enhanced inhomogeneous. The Lip/Cr, Cho/Cr, Cho/NAA values of lymphoma parenchyma were signiifcantly higher than that of peritumoral eduma (P<0.01), the Cho/Cr, Cho/NAA values of peritumoral eduma were signiifcantly higher than that of contralateral control area (P<0.01). ADC value had a decreasing trend in lymphoma parenchyma, peritumoral eduma and contralateral control area.ConclusionMRS and DWI could display the pathological change in primary central nervous system lymphoma unambiguously, they have high value in clinical diagnosis.