CT, conventional, and functional MRI features of skull lymphoma: a series of eight cases in a single institution
With the hypothesis that the combination of CT, conventional, and functional MRI can indicate a possible diagnosis of skull lymphoma, this study aimed to systematically explore CT, conventional, and functional MRI features of this rare entity.
Materials and methods
This retrospective study included eight patients with pathologically confirmed skull lymphomas. CT and conventional MRI findings, including the location, size, attenuation/signal intensity, cystic/necrosis, hemorrhage, calcification, enhancement, skull change, brain parenchyma edema and adjacent structure invasion, were reviewed. We also reviewed multi-parametric functional MR imaging features obtained from diffusion-weighted imaging (DWI, n = 4), susceptibility-weighted imaging (SWI, n = 3) and dynamic susceptibility-weighted contrast-enhanced perfusion-weighted imaging (DSC-PWI, n = 1).
The eight patients in this series consisted of five males and three females, with a mean age of 51.1 years. All skull lymphomas showed the tumors extending to extra- and intra-cranial spaces with permeative destruction of the intervening skull. Intratumoral cystic/necrosis was seen in one case. Hemorrhage or calcification was absent. Dural mater infiltration was detected in all cases. Two clivus lymphomas encased internal carotid artery without narrowing the lumen. Three cases invaded brain parenchyma with moderate edema. The tumors demonstrated high signal on DWI with low ADC values comparing to muscles. SWI images showed little intratumoral hemorrhage and vessel. Low relative cerebral blood volume (rCBV) value was detected.
Skull lymphomas commonly presented as a homogenous solid tumor extending either intra- or extra-cranially with permeative bone destruction. Restricted diffusion, little intratumoral susceptibility signal, and lower perfusion may indicate a specific diagnosis. Multi-parametric functional MRI may be a promising tool for the diagnosis of skull lymphomas.
KeywordsSkull lymphoma DWI DSC-PWI SWI
Z.X. carried out the statistical analyses and image post-processing. H.H. performed the study and drafted the manuscript. Z.X. and X.Y. performed the scanning sequences. Y.L. analyzed the case histories. D.C. conceived the study idea, participated in its design, and helped in drafting the manuscript. All authors read and approved of the final manuscript.
This study was funded by the Leading Project of the Department of Science and Technology of Fujian Province (No. 2016Y0042), and the Special Funds of Provincial Finance of Fujian Province (No. BPB-CDR2013).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and local Ethical Committee, and with the 1964 Helsinki Declaration and its later amendments. For this type of study formal consent is not required.
For this type of study formal consent is not required.
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