MRI appearances of primary central nervous system lymphoma

Objective To explore the MRI appearances and the differential diagnosis value of the primary central nervous system lymphoma(PCNSL). Methods MRI appearances of 15 patients with PCNSL which were proven by surgery and pathological examination were analyzed retrospectively. Results All patients were confirmed as the diffuse larger B-cell lymphoma pathologically. Nineteen lesions were identified in 15 patients, 13(87%) were identified to have solitary tumor foci and the other 2(13%) presented a multifocal form with a total of 6 lesions. Most lesions were located near the surface or middle line of brain. On T1 WI, the lesions showed isointensity or hypointensity. On T2 WI or FLAIR images, most lesions presented isointensity or slightly hyperintensity. On DWI,the lesions presented hyperintensity. All lesions were enhanced markedly, the typical cases presented in cision sign and angular sign, especially for these lesions adjacent to the subarachnoid space. Three lesions were showed microcystic foci and the presence of ring sign after gadolinium in jection. Conclusion The MRI appearance of PCNSL has the specificity. Preoperative MRI is helpful for the diagnosis and differential diagnosis. Correct diagnosis could be made before operation when imaging findings are considered together with clinical data.