区分多灶性胶质母细胞瘤 (GB) 和多灶性中枢神经系统淋巴瘤 (mCNSL) 可能具有挑战性，因为这些癌症在磁共振成像 (MRI) 上首次出现时具有一些共同特征。本研究的目的是探讨 mGB 与 mCNSL MRI 结果的形态学差异，并开发一种具有高诊断准确性的解释算法。在这项回顾性研究中，比较了 2015 年期间治疗的 50 名 mGB 患者和 50 名 mCNSL 患者的 MRI 特征2020年和2020年。评估了以下参数：大小、形态、病灶位置和分布、流体衰减反转恢复序列上病灶之间的连接、对比增强模式以及肿瘤内和周围的表观扩散系数（ADC）值水肿，以及 MR 灌注和磁敏感加权成像 (SWI)。总共分析了 187 个 mCNSL 病变和 181 个 mGB 病变。与 mGB 病变相比，mCNSL 病变经常表现出实性形态，mGB 病变更常表现出囊性、混合囊性/实性形态和皮质浸润。 mCNSL 病变的平均测量直径显着小于 mGB 病变 (p<<0.001)。 mCNSL 中的肿瘤 ADC 比率显着小于 mGB 中的肿瘤 ADC 比率（0.89±0.36 比 1.05±0.35，p<0.001）。 mCNSL 中病灶周围水肿的 ADC 比率显着高于 mGB 中 (p<0.001)。在SWI/T2*加权成像中，mCNSL中的肿瘤相关磁敏感伪影比mGB中更常见（p<0.001）。病灶大小、病灶与邻近组织的ADC比值以及病灶的血管化情况在 MR 灌注中发现 mCNSL 和 mGB 具有显着的独特模式，允许在初始 MRI 上对这两个实体进行放射学区分。基于这些参数的诊断算法值得前瞻性验证。© 2024。作者。

Differentiating between glioblastoma (GB) with multiple foci (mGB) and multifocal central nervous system lymphoma (mCNSL) can be challenging because these cancers share several features at first appearance on magnetic resonance imaging (MRI). The aim of this study was to explore morphological differences in MRI findings for mGB versus mCNSL and to develop an interpretation algorithm with high diagnostic accuracy.In this retrospective study, MRI characteristics were compared between 50 patients with mGB and 50 patients with mCNSL treated between 2015 and 2020. The following parameters were evaluated: size, morphology, lesion location and distribution, connections between the lesions on the fluid-attenuated inversion recovery sequence, patterns of contrast enhancement, and apparent diffusion coefficient (ADC) values within the tumor and the surrounding edema, as well as MR perfusion and susceptibility weighted imaging (SWI) whenever available.A total of 187 mCNSL lesions and 181 mGB lesions were analyzed. The mCNSL lesions demonstrated frequently a solid morphology compared to mGB lesions, which showed more often a cystic, mixed cystic/solid morphology and a cortical infiltration. The mean measured diameter was significantly smaller for mCNSL than mGB lesions (p < 0.001). Tumor ADC ratios were significantly smaller in mCNSL than in mGB (0.89 ± 0.36 vs. 1.05 ± 0.35, p < 0.001). The ADC ratio of perilesional edema was significantly higher (p < 0.001) in mCNSL than in mGB. In SWI / T2*-weighted imaging, tumor-associated susceptibility artifacts were more often found in mCNSL than in mGB (p < 0.001).The lesion size, ADC ratios of the lesions and the adjacent tissue as well as the vascularization of the lesions in the MR-perfusion were found to be significant distinctive patterns of mCNSL and mGB allowing a radiological differentiation of these two entities on initial MRI. A diagnostic algorithm based on these parameters merits a prospective validation.© 2024. The Author(s).