The MRI diagnosis of intracranial primary central nervous system lymphoma

WANG Xilu ing; WANG Xuan; ZHANG Zo gnjun; ZHAO Yane; JI Xueman

Abstract：Objective To study the MRI features of intracranial primary central nervous system lymphoma ( PCNSL) , and to improve its diagnosis and different diagnosis .Methods A retrospective review of 45 cases of intracranial PCNSL proved by histo-pathology was performed .Images were reviewed with respect to location , lesion number , size, signal intensity and enhancement characteristics.Results The average age was 51.4 years old for 45 patients, including 27 males and 18 females.A total of 71 lesions were identified, solitary lesion in 27(43.3%) patients, multiple lesions in 26(35%), 49.3% of the lesions (35/71) were located in cerebral hemisphere , 38%lesions in cerebral deep , midline regions or intraventricular , 12.7%lesion in the pos-terior fossa or brain stem .Forty-two patients include 65 lesions contacting a CSF surface .Necrosis were seen in 9 lesions (12.7%) and hemorrhage in 6 lesions.Most lesions were isointense to grey matter (81.6% on on T1WI and 73.2% T2WI). With diffusion-weighted imaging , 90.1%lesios was restricted diffusion .On post enhanced imaging , 84.5%lesion demonstrated marked enhancement , and 78 .9%lesion showed nodular or mass enhancement .Conclusion Characteristic imaging features of intracranial PCNSL include lesions contacting a CSF surface , isointense to grey matter on T1WI and T2WI imaging,nodular or mass marked enhancement and restricted diffusion with rarely necrosis .These features should be useful to the diagnosis and differ-ential diagnosis of PCNSL using the MR imaging .