The applicatio n value of DWI and enhanced scan in the case of the primary lymphoma

LI Li; CHEN Tao; REN Zhuanqin; SUO Lingyun; XI Yu

Abstract：Objective To explore the value of MR diffusion weighted imaging(DWI)and contrast-enhanced scan in the diag-nosis and differentiative diagnosis of primary cerebellar lymphoma.Methods The characteristic of conventional MRI,DWI and enhanced scanning in 5 cases with cerebellar lymphoma which were confirmed by surgery and pathology were retrospectively ana -lyzed.Quantitative determination of tumor parenchyma of apparent diffusion coefficient(ADC)value of all cases were analyzed as well.We selected 4 cases of solid hemangioblastomam,8 cases of medulloblastoma,10 cases of meningothelioma to analyze the character of DWI and contrast-enhanced scan which were confirmed by surgery and pathology,as a comparison.Results There were 3 cases with signal lesion and 2 cases with multiple lesions in 5 cases of lymphoma.A total of 8 lesions were included re-search.MR scan showed iso-or hypo-intense signal on T1WI and slightly hyperintense signal on T 2WI,in which 2 lesions in one case showed hypointense signal on T 2WI.2 lesions on DWI showed hypo-intense signal,1 lesion showed iso-intense,the remain-der lesions showed hyperintense signal.A majority of lesions in contrast-enhanced scan showed homogeneous intense enhance-ment,1 lesion showed heterogeneous intense enhancement.By comparing with DWI and contrast-enhanced scan, average ADC value of tumor was(0.66 ±0.10)×10-3mm2/s.3 lesions involved the adjacent meninges which showed thickening and enhance -ment of meninges in contrast-enhanced scan.Solid hemangioblastoma showed an intense enhancement and hypointense signal on DWI.Average ADC value of parenchyma area was(1.93 ±0.13)×10-3mm2/s;Medulloblastoma showed a moderate or intense enhancement and hyperintense signal on DWI.Average ADC value of parenchyma area was(0.71 ±0.11)×10-3mm2/s.Menin-gothelioma showed a moderate or intense enhancement,dural tail sign was shown in 6 cases.On DWI sequence,5 cases showed iso-intensity signal,3 cases showed slightly hypointense signal,2 cases showed slightly hyperintense signal.Average ADC value of parenchyma area was(1.07 ±0.22)×10-3mm2/s.ADC values of lymphoma tend to be the minimum which followed by Solid hemangioblastoma.Solid hemangioblastoma showed a high degree of enhancement which followed by lymphoma.Conclusion Application of DWI combined with contrast-enhanced scan in the diagnosis and differentiative diagnosis of screen lymphoma is of great value,which can significantly improve the diagnostic accuracy of lymphoma.