椎管内胚胎性肿瘤的MRI诊断及其信号的病理基础

目的：探讨椎管内胚胎性肿瘤的ＭＲＩ表现特点，评价其诊断价值。材料及方法：经手术病理证实的椎管内胚胎性肿瘤８例，分析其ＭＲＩ表现并与病理对照。结果：表皮样囊肿（５例）有４例表现为Ｔ１ＷＩ略低、Ｔ２ＷＩ高信号，１例为Ｔ１ＷＩ略高、Ｔ２ＷＩ等信号；皮样囊肿（１例）Ｔ１ＷＩ表现为略高及极高信号；畸胎瘤（２例）Ｔ１ＷＩ为等、高、低混杂信号。病变均具有等信号的包膜，均未见增强，表皮样囊肿及皮样囊肿均合并有多种脊柱及脊髓的先天畸形，畸胎瘤未见先天畸形。结论：椎管内胚胎性肿瘤ＭＲＩＴ１ＷＩ图像的ＭＲ信号具有特殊性，ＭＲ信号反映了瘤内组织成分，结合肿瘤多不增强及多伴有先天畸形特点，ＭＲＩ对胚胎性肿瘤具有定性诊断价值

The MRI Diagnostic Study of Embryonal Tumors in Spinal Canal and Pathologic Manifestation of It's Signa Instensity

Purpose: To discuss the role of MRI in the presentations and diagnosis of embryonal tumors in the spinal canal. Materials and Methods: The MRI data of 8 cases of embryonal tumors in the spinal canal were analyzed. combined with the surgical and pathological observations. Results: 4 of the 5 cases of epidermoids had the characteristics of moderate low signal intensity on T 1WI and high intensity on T 2WI, while the other 1 demonstrated moderate high signal intensity on T 1WI and iso intensity on T 2WI; Dermoids (1 case) demonstrated moderate to extremly high signal intensity on T 1WI. Teratomas (2 cases) heterogeneously demonstrated high, low or iso intense signal on T 1WI. All the lesions had a capsule demonstrating iso intensity and no contrast enhancement of T 1WI. Congenital deformation in the spine and spinal cord was complicated with dermoid and epidermoid, but not with teratoma. Conclusion: Different embryonal tumors in the spinal canal had their own characteristics in the signal insensity of T 1WI, which might demonstate the histology of tumor tissue. Because most embryonal tumors in the spinal canal demonstrate no contrast enhancement and are often complicated with congenital deformation, MRI is valuable in the differentiation of these tumor.