椎管内蛛网膜囊肿的MRI诊断

目的探讨椎管内蛛网膜囊肿的MR I表现。方法搜集20例经MR I检查,手术病理证实的椎管内蛛网膜囊肿进行回顾性分析,其中男8例,女12例,行横断面及矢状面MR常规SE序列扫描,12例加做Gd-DTPA增强扫描。结果椎管内硬膜外蛛网膜囊肿5例,椎管内硬膜下蛛网膜囊肿6例,骶管内蛛网膜囊肿8例,神经鞘膜囊肿1例。囊肿信号与脑脊液信号相同,呈长T1、长T2信号,增强扫描无强化。结论MR I是诊断椎管内蛛网膜囊肿的最佳方法,平扫加增强扫描有助于诊断和鉴别诊断。     

硬脊膜下结石并蛛网膜囊肿一例报告

女,52岁.主诉头痛月余,腹部及两下肢麻木3个月.前者经对症治疗已好转,而后者逐渐加重,直到痛温觉减退,行走困难来院求治.入院后神经系检查:双下肢肌力(?)度.肌张力高,行走困难,胸椎7～8以下深.浅     

椎管内蛛网膜囊肿MRI表现及诊断价值

目的 分析椎管内蛛网膜囊肿MRI特点及其诊断价值。资料与方法 搜集经手术病理证实的椎管内蛛网膜囊肿59例，其中男24例，女35例，行横断、冠状及矢状面MR SE序列扫描，8例加做Gd—DTPA增强扫描。结果 椎管内硬膜外蛛网膜囊肿4例，骶管内蛛网膜囊肿42例，神经鞘膜囊肿10例，椎管内硬膜下蛛网膜囊肿3例。囊肿T1WI呈低信号，T2WI呈高信号，囊液信号与脑脊液信号一致。59例定位、定性诊断全部正确。结论 椎管内蛛网膜囊肿的MRI表现较具特征性，MRI可对其作出正确诊断，并指导手术。     

急性硬脊膜外血肿的MRI研究

目的 探讨急性硬脊膜外血肿(ASEH)的发病机制、MRI表现特征及鉴别诊断。方法 15例ASEH病人，男8例，女7例，平均37．8岁。5例有脊柱损伤史，1例有脊柱手术史，1例有腰硬脊膜穿刺史，其余8例无特殊病史。11例经手术证实，2例经CT引导穿刺抽吸治疗并证实，2例经临床相应检查及随访证实。所有病人均行矢状面SE T1WI和快速SE(FSE)或SE T2WI。12例行横轴面FSE T2WI，8例行SE T1WI。4例行SE T1WI增强扫描。结果 15例血肿共发生于18个脊柱节段，其中6例次(6／18)位于颈段、9例次(9／18)位于胸段、3例次(3／18)位于腰段。7例次(7／18)血肿位于硬膜囊前方，11例次(11／18)位于硬膜囊后方。血肿累及1～13个椎体高度，平均4．87个椎体高度。T1WI上，所有血肿与脊髓之间均显示有线样低信号区。T2WI矢状面和横轴面上，分别有4例(4／15)和8例(8／12)在血肿与蛛网膜下腔之间显示有低信号线。矢状面上13例(13／15)血肿呈长梭形，横轴面上均呈双凸镜形或半圆形。SE T1WI上，5例呈等T1信号，6例呈短T1信号，4例呈等、短T1混杂信号；T2WI上，5例呈短T2信号，10例呈短、长T2混杂信号。4例增强扫描无特异性。结论 ASEH的MRI表现具有特征性，可为诊断及鉴别诊断提供依据。     

骶管内脊膜囊肿的MR诊断

目的　探讨骶管内脊膜囊肿的临床表现、MR诊断及鉴别诊断。方法　 2 5例骶管内脊膜囊肿 ,均经手术病理证实。其中男 9例 ,女 16例 ,年龄 18～ 56岁 ,平均 40 .3岁。所有病例均行MR检查。结果　囊肿位于骶管内 ,呈卵圆形 19例 ,长条状囊袋形 3例 ,不规则形 1例 ,串珠形 2例。囊肿境界清楚 ,囊壁菲薄 ,囊液信号与脑脊液信号相似 ,T1WI囊液呈均质性低信号 ,T2 WI囊液呈高信号 ,8例T2 WI囊液信号较脑脊液信号更高。其中 7例囊肿内于T1WI和T2 WI可见细条状神经根影。 8例增强扫描囊液、囊壁无增强。结论　MR是骶管内脊膜囊肿最佳的检查方法之一 ,正确认识其MR征象不仅能够准确诊断 ,而且可以指导临床治疗方案的选择。     

骶管脊膜囊肿的MR评价

回顾性分析ＭＲＩ发现的 18例骶管脊膜囊肿 ,旨在探讨骶管脊膜囊肿ＭＲＩ征象与引发临床症状的关系。1　材料与方法　　 18例中 ,男性 6例 ,女性 12例 ,年龄 2 2～ 6 8岁。全部病例按以下情况分为三组。 (1)有症状组 4例 ,表现腰部、会阴部胀痛不适等马尾神经受累症状 ,经手术切除囊肿症状消失。 (2 )无症状组 10例 ,6例无腰痛 ,作盆腔ＭＲＩ时发现 ,4例有一侧腰腿痛 ,但症状与囊肿不相关。 (3)未确定组 4例 ,有一般腰痛症状 ,不影响日常工作 ,腰椎及椎间盘有轻度退行性变 ,无其他伴发疾病。着重分析、比较有症状组和无症状组的ＭＲＩ表现与…     

椎管内脊膜瘤和神经鞘瘤MRI鉴别

目的分析椎管内脊膜瘤和神经鞘瘤的MRI特点,以得出两者重要鉴别意义的影像学表现。方法回顾性分析29例椎管内脊膜瘤和神经鞘瘤的MRI影像学特征。结果①脊膜瘤组的纵径和横径具有显著差异(P<0.01),且纵径大于横径;神经鞘瘤组的纵径和横径无明显统计学差异(P>0.05);②以下8个因素在脊膜瘤和神经鞘瘤之间的差异具有非常显著的意义(P<0.01),分别是:肿瘤形态、邻近椎间孔扩大、肿瘤与硬膜面夹角、脊膜尾征、肿瘤内部坏死、囊变、T1WI信号强度、T2WI信号强度及T2WI信号混杂性;③性别、发病部位、环状强化因素在脊膜瘤和神经鞘瘤之间的差异具有显著意义(P<0.05)。结论 MRI对椎管内脊膜瘤和神经鞘瘤的鉴别有重要价值。     

脊膜瘤的MRI诊断及临床分析

目的 探讨脊膜瘤的MRI诊断及相关临床分析.方法 回顾性分析经手术治疗确诊的75例脊膜瘤病人的MRI检查及临床资料.结果 75例均为单发,颈椎20例,胸椎53例,腰椎2例.72例发生在椎管内髓外硬膜下,3例发生在硬膜外.椎管内背侧60例,腹侧12例,3例累及椎管内外.圆形及卵圆形50例(占66.7%),宽基底丘状22例(约占29.0%),哑铃状 3 例 ( 约占 4.3%).1例哑铃状肿瘤最大,大小约4.0 cm×3.5 cm×1.5 cm.最小肿瘤直径约1.5 cm.FSE T1WI以等低信号为主,T2WI以等或略高信号为主.增强扫描,绝大多数肿瘤呈明显均匀强化,27例出现"硬膜尾征".病人术前主要临床表现为肢体麻木无力,行走不稳.术后随访65例,症状明显好转组50例,不明显好转或加重组15例.结论 通过MRI检查,绝大多数脊膜瘤可以正确诊断.     

Myelographic and MRI appearances of a thoracic spinal extradural arachnoid cyst of the spine with extra-and intraspinal extension

Summary An unusual arachnoid, cyst of the thoracic spine is reported. The clinical and neuroradiological features are described.     

Imaging of thoracic and lumbar spinal extradural arachnoid cysts: report of two cases

Extradural arachnoid cysts are uncommon expanding lesions in the spinal canal which may communicate with the subarachnoid space. Usually in the lower thoracic spine, they may cause symptoms by compressing the spinal cord or nerve roots. We report cases of thoracic and lumbar arachnoid cysts studied by cystography, myelography, CT and MRI. These techniques showed extradural cystic lesions containing cerebrospinal fluid, with variable communication with the subarachnoid space, causing anterior displacement and flattening of the spinal cord. Received: 3 November 1995 Accepted: 16 April 1996     

Contrast-enhanced MRI of intrasellar arachnoid cysts: relationship between the pituitary gland and cyst

We recently encountered two large intrasellar arachnoid cysts extending to the suprasellar region. The intensity of the cyst contents was identical to that of the cerebrospinal fluid on both T1- and T2-weighted MRI. On contrast-enhanced MRI, the pituitary gland was compressed posteroinferiorly and flattened in the sella turcica. In this report of rare intrasellar arachnoid cysts the discussion is focused on dislocation of the pituitary gland.     

An unusual spinal intradural arachnoid cyst

Spinal intradural arachnoid cysts are seen most frequently in the thoracic region, particularly near the midline posteriorly. A thoracic intradural arachnoid cyst in this typical location is reported, with the additional unusual finding of herniation of the spinal cord through an anterior defect in the dura mater. The MRI findings are described.     

MRI of extradural spinal tumours at 0.3 T

Ninety-one patients with extradural spinal tumours were examined by magnetic resonance imaging. There were 76 metastases (6 from unknown primary tumours). Seven patients had primary spinal tumours and 8 had multiple myeloma. Sixteen had bulging, diseased vertebral bodies compressing the subarachnoid space and 67 had extradural tumour compressing the spinal cord. Sixty patients had paravertebral involvement. Intraspinal involvement did not correlate with the extent of spinal lesions. All patients had vertebral destruction, with hypointense or combined hypo- and isointense signal relative to bone marrow on T1-weighted images. In most of the 22 patients with T2-weighted images the tumours were isointense or slightly hyperintense. It was usually impossible to differentiate the various tumours on the basis of signal intensity and morphology. However, metastases from carcinoma of the prostate were often more hypointense than other tumours on T1- and T2-weighted images. An inhomogeneous pattern in which diffusely low signal is combined with focal lower signal on T1-weighted images may suggest myeloma. In the 22 patients examined with both T1- and T2-weighted images, T1-weighted images gave the best information in 18; in 3 they were equivalent and in 1 inferior to T2-weighted images; they are therefore recommended for routine imaging of epidural spinal tumours.     

The MRI signs of spinal arachnoid diverticula

Our goal was to find MRI signs of use for identifying a spinal arachnoid diverticulum. Three cases of spinal arachnoid diverticula, one extradural and two intradural, were examined on a 1.5 T imager. There was obvious mass effect on the adjacent structures in one case and increased signal intensity in the diverticulum on proton density- and T2-weighted images in two cases. Signal changes due to turbulent movement of the spinal fluid inside the diverticula were seen in all cases on sagittal fast spin-echo (FSE) proton density- and T2-weighted images; it was difficult to tell whether these signal changes imply a communication or are simply FSE artefacts. On contrast-enhanced studies, all cases showed partial enhancement inside the diverticula. There thus are four signs of diverticula: mass effect, the increased signal, signal void sign and partial enhancement; the last of these, the most reliable, has never been reported before. Received: 22 December 1995 Accepted: 26 July 1996     

鼻咽潴留囊肿的 MRI诊断

目的：评价MRI对鼻咽潴留囊肿的诊断价值。方法：回顾性分析8例经手术穿刺及病理证实的鼻咽潴留囊肿的MRI表现。结果：MRI表现为：８例鼻咽潴留囊肿呈圆形,边界清晰,Ｔ１ＷＩ上６例呈低信号,２例呈稍低信号,Ｔ２ＷＩ均呈高信号。结论：ＭＲＩ对鼻咽潴留囊肿的诊断具有较高的敏感性和特异性。是诊断鼻咽潴留囊肿的重要方法。     

弥散加权成像与MRI增强诊断表皮样囊肿的比较研究

目的:比较弥散加权成像(DWI)与MRI增强(CE-MRI)对表皮样囊肿的检出敏感性,评价DWI的临床应用价值.方法:对59例初次检查及66例术后复查疑似表皮样囊肿的患者行回顾性研究,所有病例均行常规序列[T1 WI、Tz WI、液体衰减反转恢复序列(FLAIR)]、弥散加权成像(DWI)和钆对比剂增强扫描(CE-MRI)检查.将所有图像分为DWI结合常规序列(Ⅰ组)、CE-MR1结合常规序列(Ⅱ组)及DWI联合CE-MRI并结合常规序列(Ⅲ组)三组进行判断,诊断结果与手术病理进行比较,判定三组检查方法的敏感性,组间比较采用配对资料的x2检验.另外选择32例经病理及随访观察证实的蛛网膜囊肿做对照,分析信号特征并测量ADC值,与表皮样囊肿ADC值的比较采用配对t检验.结果:Ⅰ组、Ⅱ组诊断表皮样囊肿的敏感性分别为90.5％、57.8％,二者具有明显统计学差异(x2=25.714,P＜0.01).Ⅲ组诊断表皮样囊肿的敏感性为91.8％,与11组具有明显统计学差异(x2=30.250,P＜0.01),与Ⅰ组没有统计学差异(x2=0.250,P＞0.05).病理证实的88例表皮样囊肿DWI均呈明显高信号,32例蛛网膜囊肿DW1均呈明显低信号,表皮样囊肿的ADC值(1.06士0.21×103)mm2/s明显低于蛛网膜囊肿的的ADC值(3.24±0.39×101)mm2/s,两者比较差异有统计学意义(t =-3.647,P＜0.01).结论:DWI较MRI增强检查对表皮样囊肿具有较高的检出率,在与蛛网膜囊肿的鉴别及判断表皮样囊肿复发上能提供有价值的诊断信息.     

Intracranial arachnoid cysts in myotonic dystrophy

Summary Clinically apparent brain dysfunction is common in myotonic dystrophy. In a sample of fourteen adult patients with the definite form of this disease, brain magnetic resonance imaging detected frequent white matter abnormalities and ventriculomegaly. In addition, two patients exhibited an intracranial arachnoid cyst, a condition of neurosurgical interest that could be related to the generalized dysmaturational process present in this disease. Patients with myotonic dystrophy deserve a careful screening for brain involvement. Further MRI studies should ascertain the actual prevalence of brain anomalies in myotonic dystrophy and define the role of this procedure in the workup of this disease.     

椎管内神经鞘瘤的低场MRI诊断

目的:探讨椎管内神经鞘瘤的低场MRI表现及诊断价值。方法:搜集12例经手术病理证实的椎管内神经鞘瘤,重点分析其MRI特点及发病部位。结果:本组病例肿瘤均为单发,T1WI肿瘤呈低或等信号,T2WI呈高信号,增强后显著强化,12例肿瘤病理均无钙化。MRI对椎管内神经鞘瘤定位诊断符合率100%,定性诊断符合率83.3%。结论:低场MRI可作为诊断椎管内神经鞘瘤的敏感检查方法,正确认识其MRI征象能帮助术前诊断,并指导手术。