Role Of MRI In Differential Diagnosis Of Glioblastoma Multiforme And Primary Central Nervous System Lymphoma

ObjectiveTo investigate the diagnosis value of MRI T1 WI enhancement and AD C in glioblastoma multiforme(GBM)and primary central nervous system ly mphoma(PCNSL).MethodsCollected 81 patients of GBM and 26 patients of PCNSL(9 patients of1 focal area,6 patients of 2 focal areas,5 patients of 3 focal areas,no ne patient of 4 focal areas,6 patients of 5 focal areas;66 focal areas in total),who were confirmed by surgery and pathology from July 2017 to December 2020 in our Hospital.All of this patients underwent MRI plain s can,enhanced and Diffusion-weighted imaging(DWI)examination to obser ve the tumor imaging manifestations and T1 WI sequence enhancement ch aracteristics.Measure and compare the ADC values of the two groups of tumors.ResultsThe enhancement MRI T1 WI signal of GBM is not uniform,cystic degeneration and necrosis are common in tumors of higher grade,and T1 WI enhancement is obvious.The 46.9% of the focal areas showed garlan d or irregular ring enhancement,the diffusion was obviously limited,and t he 65.4% of the focal areas have edema around them.The 61.7% of the foc al areas compressed the brain or ventricles,the 74.1% of the focal areas caused midline displacement,and the space-occupying effect is obvious;The T1 WI enhancement signal of PCNSL is uniform,and diffusion is limited,the 65.2% of the focal areas have obvious enhancement or heterogeneou s enhancement,the 22.7% of focal areas showed peripheral edema,the 18.2% of the focal areas compressed the brain or ventricles,and only 1.5% of the focal areas caused midline displacement,which was not obviou s compared with GBM.Compared with the position effect,the difference was statistically significant(P<0.05),PCNSL focal areas are mostly distribu ted in the parietal lobe,frontal lobe and basal ganglia,and the lesions ar e mostly patchy and nodular,with uniform enhancement;GBM focal areas are mostly distributed in the frontal lobe,temporal lobe and occipital lobe.The shape of the lesions is mostly mass,with obvious space-occupying effect,and most of them are rosette-like or ring-shaped enhancement.The ADC value of GBM was lower than the ADC value of PCNSL,and the d ifference was statistically significant(P<0.05).Conclusion1.PCNSL is more common in the parietal and basal ganglia region,GBM is more common in the temporal and occipital lobes,and both of tw o diseases are conmon in frontal lobes.Uniform enhancement suggested PCNSL,and obvious mass effect,garland or irregular ring enhancement s uggested GBM.2.MRI scan parameter ADC value can better distinguish GBM from P CNSL and improve the accuracy of diagnosis.