The Medical Imaging Assessment Of Primary Central Nervous System Lymphoma

Objective To evaluate the medical imaging diagnosis of primary central nervous system lymphoma(PCNSL), find its similar characteristics in order to improve accuracy of medical imaging diagnosis. Methods From 2002 to 2012, Neurosurgical Department of Changzhou First People’s Hospital admitted 8 patients diagnosed PCNSL with post-operative pathological examination, their retrospective medical imaging analysis were evaluated. All patients were followed up by medical imaging after discharged. Results Their medical imaging materials, especially MRI and its extended examinations, had characteristics in common. Mostly, CT and MRI scan showed the site of lesion was located in the cerebral white matter, peritumoral brain edema was common to be seen, while cystic formation, hemorrhage and heterogeneous with calcifications was quite rare. Lesions displayed homogeneous contrast enhancement with irregular shape on MRI scan. It has the characteristics of leaves sign(4 cases, 50%), semilunar sign(3 cases, 37.5%), concave sign(3 cases, 37.5%), tip sign(2 cases, 25%), sleeves sign(2 cases, 25%) and fist sign(1 case, 12.5%). 2 cases performed high signals on DWI manifestation, while ADC value remained low. 2 cases’ PWI showed enhancement, such as high rCBV and rCBF values. 2 cases’ NAA value remained low on MRS performance, Cho tip stayed obviously high, Cr tip showed slightly low. The accuracy of PCNSL diagnosis was only 25% before pathological examination confirmed. Conclusions PCNSL, with high rate of misdiagnosis due to its similar performance on medical imaging, has certain characteristic clinical manifestation on MRI materials, which could make contributions to the diagnosis and differential diagnosis of PCNSL.