MRI diagnosis and differential diagnosis of intracerebral primary non-Hodgkin lymphoma

Objective:To analyze the MRI features of primary intracerebral non-Hodgkin lymphoma (NHL),in order to improve the accuracy of diagnosis and differential diagnosis.Methods:MRI findings of 20 cases with primary intracerebral NHL proved by surgery and stereotactic biopsy were retrospectively analyzed.MRI plain scans were performed in all patients and contrast-enhanced scans were performed in 19 patients,while only 1 patient had MR diffuse-weighted imaging (DWI).Results:Of the 20 cases,single lesion was seen in 15 and multiple lesions in 5 cases,totally 28 lesions were assessed.The location of lesions included supratentorial region (18 cases) and infratentorial region (2 cases).The supratentorial lesions were mainly deeply seated,located at paraventricular region including basal ganglia (9 cases),cerebral hemisphere (6 cases) and corpus callosum (3 cases).The lesions showed iso-intensity on T1WI and T2WI in 13 cases and slightly hypointensity on T1WI and slightly hyperintensity on T2WI in 7 cases,and showed high signal intensity in that patient having DWI.Most of the lesions were well-circumscribed,round or irregular in shape,2 patients had nodular lesions.After contrast administration,the lesions showed markedly homogeneous enhancement in 13 cases and heterogeneous enhancement in 6 cases.There were fist clenching sign- in 11 cases,angular sign in 13 cases and notch sign in 9 cases after enhancement.Conclusion:Certain characteristic findings could be revealed on MRI in primary intracerebral NHL patients.Preoperative MRI is helpful for the diagnosis and differential diagnosis and plays an important role in treatment planning.