目的探讨原发性中枢神经系 统淋巴瘤(primary central nervous system lymphoma, PCNSL)的CT、MRI特征 及病理学基础。方法 回顾性分析18例经 病理证实PCNSL的 CT、MRI和病理资料。 结果 ①18例共26个病灶，位于基底节区6 个、胼胝体5个、丘脑5个、脑室旁深部白 质6个、大脑半球浅部4个。14例呈团块结 节状，4例呈蝴蝶状；6例水肿明显，12例 水肿较轻。②CT平扫6例呈稍高密度，2例 呈等密度；增强扫描均明显强化。③MR平 扫T1WI 14例呈稍低信号,4例呈等信号； T2WI呈稍高信号14例,等或稍低信号4例； DWI均呈高或稍高信号。增强扫描均明显 强化，其中4例周围强化较明显呈“环 征”，4例呈“蝴蝶状”，6例呈“握拳 征”，2例呈“尖角征”，2例呈类圆形。 8例行1H-MRS检查,均出现NAA峰不同程度 减低, Cho峰明显升高，7例Lip峰明显升 高，4例出现Lac峰。结论 PCNSL的CT和 MRI表现有一定特征，综合分析CT及MRI征 象，可以做出正确诊断。

Objective To explore the pathological manifestation and CT、MR findings of primary central nervous system lymphoma (PCNSL). Methods 18 cases'CT、MRI and pathological datas confirmed with PCNSL were retrospectively analyzed. Results ① There were 18 cases with 26 lesions, and 6 lesions located at the basal ganglia, 5 lesions at corpus callosum, 5 lesions at thalamus, 6 lesions at periventricular deep white matter, 4 lesions at cerebral hemisphere shallow. 14 cases showed nodular mass, 4 cases of butterfly-shaped. 6 cases with edema, 12 cases with mild edema. ② CT scan: 6 cases showed slightly higher density, 2 cases showed equal density; enhanced scan showed significantly enhanced. ③ MR scan: T1WI 14 cases showed slightly lower signal and 4 cases showed equal signals on T1WI; T2WI 14 cases showed slightly higher signal and 4 cases showed equal signals on T2WI, all showed high or slightly higher signal on DWI. Enhanced scan: all significantly enhanced, including 4 cases with peripheral enhancement more visible with "ring sign", 4 cases showed "butterfly-like", 6 cases showed "fist sign", 2 cases showed "sharp sign", 2 cases were round. 8 cases with 1H-MRS examination, NAA peak reduced of varying degrees, Cho peak significantly increased, 7 cases with Lip peak increased significantly, 4 cases with Lac peak. Conclusion CT and MRI findings of PCNSL had certain characteristics, comprehensive analyzed the CT and MRI features could make correct diagnosis.