Comparative Analysis Among Multimodal MRI and Pathology of Primary Central Nervous System Lymphoma

Objective To explore the pathological manifestations and multimodal MRI features of primary central nervous system lymphoma(PCNSL),in order to improve the accuracy of diagnosis of the disease.Methods 15 cases of PCNSL proved by pathology were collected in the study analyzed retrospectively,including MRI manifestations and pathological data.Results 15 cases were non-Hodgkin's lymphoma,14 cases of B-cell and 1 cases of T-cell.Nine cases had single lesion and six cases had multiple lesion.Total 24 lesions were found.Lesions occur in the supratentorial region(22),mainly located in the deep white matter near the midline infratentorial.Lesion occur in the infratentorial is rare.The lesions showed hypointensity or slightly isointensity signal on T1WI,hypointensity or slightly hyperintensity signal on T2WI and FLAIR.9 lesions in mild edema,7 lesions in moderate edema,6 lesions in severe edema.The lesion is no edema around located in lateral ventricles and meninges.24 lesions of contrast enhancement were intensive homogenous such as clumping,nodosity and ringlike.4 lesions were seen cystic necrosis no enhancement.the presence of incision sign in 10 lesions,angular sign in 7 lesions,and butterfly sign in 3 lesions were more specific.The lesions of 15 cases showed slightly hyperintensity or hyperintensity signal on diffusion-weighted imaging(DWI).8 cases underwent proton magnetic resonance spectroscopy(1 H-MRS) showed moderate decreased N-acetyl aspartate(NAA) peak,slightly lower peak creatine(Cr),significantly increased choline(Cho) peak and highly elevated lipid(Lip) peak.Conclusion The pathology of PCNSL determined the MRI features,combined with multimodal means of the functional imaging of DWI and 1 H-MRS,might help to improve the accuracy of diagnosis and differential diagnosis.