脊柱硬膜外淋巴瘤与白血病的MRI鉴别诊断

目的 :探讨脊柱硬膜外淋巴瘤与白血病的MRI特征性表现 ,提高诊断与鉴别诊断水平。方法 :分析 17例经病理及临床证实的脊柱硬膜外淋巴瘤与白血病的MRI表现 ,其中淋巴瘤 13例 ,白血病 4例 ,常规MRI平扫 ,其中 11例行增强扫描。结果 :.淋巴瘤 13例中 ,10例主要累及胸椎 ,3例主要累及腰骶椎 ,矢状面T1 WI、T2 WI主要表现为脊椎弥漫性斑片、斑点状长T1 、长T2 信号 ;均并发椎管内硬膜外长梭形软组织占位 ,于横轴面呈环绕硬膜囊“半月形”、“新月形”等T1 、等T2 均匀信号。并发椎旁不规则软组织占位 4例 ,增强示椎管内硬膜外长梭形软组织占位呈均匀强化。白血病 4例 ,均表现为脊柱均匀分布的弥漫性斑片、斑点状长T1 、长T2 信号。结论 :MRI对脊柱硬膜外淋巴瘤与白血病的诊断与鉴别诊断有重要价值

MRI features and differential diagnosis of extradural lymphoma and leukemia of the spine

Objective:To study the MRI features of lymphoma and leukemia,and to improve the diagnostic accuracy . Methods:The MRI manifestations of 17 cases of extradural lymphoma and leukemia with pathological confirmation were analysed, including 13 cases of lymphoma and 4 cases of leukemia.All patients were examined with plain MR scans and 11 cases were examined with contrast enhanced MR scans.Results:Among 13 cases of lymphoma,the lesions located primarily in the thoracic vertetrae (n=10)and lumbo sacral region (n=3). All cases showed long T 1 signal and long T 2 signal,with extradural intraspinal spindle form mass.On transverse T 2WI the lesion demonstrated crescent iso intense mass around the dural sac. In leukemia,all of 4 cases showed areas of evenly distributing diffuse patchy or mottled long T 1 and long T 2 signal. Conclusion:MRI has great value in diagnosis and differential diagnosis of extradural lymphoma and leukemia of the spine.