脊柱转移瘤的MRI诊断和评价

目的 研究脊柱转移瘤的MRI征象，探讨MRI对其诊断价值。方法 收集经临床病理证实的脊柱转移瘤41例，回顾性人分析其MRI表现。结果 41例脊柱转移瘤中，只累及单个椎体者6例，其余为2个以上椎体受侵，占全部病例的85.37%，其中跳跃式分布者9例。受累椎体形态呈轻度楔形变30例，鱼尾征5例，膨胀性改变4例，无明显变化2例；椎板及椎弓根等受侵28例。受侵椎体呈长T1信号、稍长T2信号30例，长T1信号，短T2信号8例，稍长T1，等T2信号1例，等T1、稍长T2信号2例。椎间盘无改变39例，占95.12%。椎间隙变窄2例。椎管内或其周围软组织肿块12例。腰大肌形态或信号异常2例。结论 MRI可作为诊断脊柱转移瘤首选检查方法，矢状面T1WI及其SPIR技术显示病变存在优于其他扫描序列。跳跃式椎体侵犯、多椎体受累、椎弓根及椎板多有破坏、椎间盘形态基本正常是脊柱转移瘤的典型表现，辅以Gd-DTPA增强或联合CT扫描对于椎管内结构受侵的诊断及其鉴别有帮助。

MRI diagnosis of metastatic spinal tumors

Objective To study the MRI features of metastatic spinal tumor and discuss the diagnostic value of MRI.?Methods The MRI features in 41 cases of pathologically-proved metastatic spinal tumor were retrospectively analyzed.?Results In 6 of the 41 cases, only one vertebral body was involved, the other 35 cases showed tumor involvement in more than 2 vertebral bodies, including 9 cases in which the lesions were in a jumping arrangement. The involved vertebral bodies showed cuniform deformity (30 cases), fishtail appearance (5), expansion (4) and normal (2). MRI of metastatic spinal tumor showed low signal on T1WI and slightly high signal on T2WI(30/41),low signal on T1WI and T2WI(8/41) slightly low signal in T1WI and isointensity on T2WI (1/41), isointensity on T1WI and slightly high signal on T2WI(2/41). The intervertebral discs appeared normal in 39 cases (95.12%). There were soft tissue masses in the spinal canal or around the spine in 12 cases, and abnormalities in the greater psoas muscle in 2 cases.?Conclusion The typical MRI features of metastatic spinal tumor include multiple involvement of vertebral bodies, often in jumping arrangement, and basically normal intervertebral discs. MRI is the first-choice means for the diagnosis of metastatic spinal tumor.