椎管内硬膜外海绵状血管瘤的MRI特征分析

目的研究椎管内硬膜外海绵状血管瘤的MRI表现特征,提高对本病的认识及诊断水平。方法回顾分析经手术病理证实的9例椎管内硬膜外海绵状血管瘤病例的临床资料,总结其MRI影像学特征。结果 9例椎管内硬膜外海绵状血管瘤病例病灶均位于胸段椎管,其中3例位于上胸段,6例位于下胸段,病灶均沿脊柱长轴生长;T1WI呈高低混杂信号,T2WI呈明显高信号,与脑脊液信号相仿。矢状位显示病灶呈梭形或卵圆形附于椎管侧后壁,相应硬膜外间隙增宽,在病灶两端形成T1WI及T2WI均为高信号的脂肪帽,呈＂笔套样＂改变,增强后病灶显著均匀强化,强化后的瘤体与高信号的脂肪帽分界不清,共同形成＂双尾样＂改变。冠状位及轴位显示病灶沿相邻椎间孔＂伪足样＂向外生长,相应椎间孔轻度增宽,骨质轻度压迫吸收。结论椎管内硬膜外海绵状血管瘤的MRI表现具有一定的特征性,多平面全方位观察有助于术前准确定位及诊断。

MRI characteristics of cavernous angiomas in the spinal epidural space

Objective To study MR characteristics of cavernous angiomas in the spinal epidural space and to improve the diagnostic ability of this disease.Methods The clinic findings of 9patients of cavernous angiomas in the spinal epidural space confirmed by operation and pathology were analyzed retrospectively,and the MRI characteristics were summarized.Results All lesions were located in thoracic segment of spine including 3lesions near the cervical segment and 6lesions near the lumbar segment.The location of lesions was distributed along the long axis of spinal cord.Tumors showed mixed signal intensity on T1 WI and obviously high signal intensity on T2 WI like cerebrospinal fluid.The lesions were fusiform or oval with the epidural space broadening on sagittal imaging.The fat hat with high signal intensity on T1 WI and T2 WI was found at the both ends,and it was like cap of a pen.All cases showed significantly uniform enhancement.The border was unclear between enhanced tumor and fat hat,and it was like two-tailed.The tumors grew pseudopod-like along the adjacent intervertebral foramen with intervertebral foramen slightly broadening and bone absorbing around.Conclusion The MR findings of cavernous angiomas in the spinal epidural space have some characteristics.Multiplanar all-round observation is useful for accurate localization and diagnosis.