椎管内表皮样囊肿的MRI诊断与临床分析

目的：探讨椎管内表皮样囊肿的临床表现特点及MRI诊断价值。材料与方法回顾性分析经手术病理证实的27例(男15例，女12例)椎管内表皮样囊肿的临床及影像资料，重点分析其X线表现及MRI特点。结果主要临床表现为单侧或双侧下肢疼痛、麻木无力或肌力减退。病变部位为骶尾段13、腰骶椎交界区4例，腰段7例，胸腰椎交界区3例。位于髓外硬膜下23例，脊髓内4例。病变长度2.7～9.0 cm不等，长轴与椎管方向一致。T1WI示8例呈均匀低信号，14例呈等低混杂信号，5例呈高低混杂信号。T2WI 6例呈均匀高信号，21例呈等高混杂信号；增强扫描，4例病变周围见不规则环形或线状强化。16例患者合并发育性骨质异常。结论椎管内表皮样囊肿以先天性多见，多伴有其它先天性发育畸形；X线检查可以发现并存的骨质异常，MRI表现具有特征性，对病变诊断及鉴别诊断有重要价值。

The MRI diagnosis and clinical study of intraspinal epidermoid cyst

Objective: To discuss the clinical characteristics and MRI diagnostic value of intraspinal epidermoid cyst. Materials and Methods:Twenty-seven cases (male 15 cases, female 12 cases) intraspinal epidermoid cyst with complete clinical and imaging data were diagnosed retrospectively, which confirmed by surgery and pathology. Results:The major clinical manifestations were unilateral or bilateral lower lamb pain, numbness weakness or strength decreased. Location of lesions were 13 in sacrococcygeal region, 4 in lumbosacral vertebral border area, 7 in lumbar segments, and 3 in thoracolumbar border area. Twenty-three lesions were in subdural space, and 4 in the spinal cord. The length of lesions was 2.7—9.0 cm, and the long axis was consistent with the spinal canal. On MRI, 8 cases showed uniformity hypo-intensity, 14 cases showed iso-/hypo-intensity, and 5 cases showed hyper-/hypo-intensity in T1WI. And 6 cases showed uniformity hyper-intensity, 21 cases showed iso-/hyper-intensity in T2WI. In contrast enhancement, only 4 cases showed irregular circular or linear peripheral enhancement. Sixteen cases complicated with other congenital bone deformation. Conclusions:The intraspinal epidermoid cyst most likely occurred congenitally, and often complicated with other congenital developmental malformation, which can be observed by X-ray photography. The intraspinal epidermoid cyst has characteristic MRI findings, which play an important role in its diagnosis and differential diagnosis.