5例椎管内硬膜外血管脂肪瘤MRI诊断

目的分析椎管内硬膜外血管脂肪瘤MRI的表现,提高椎管内硬膜外血管脂肪瘤的诊断水平.方法对手术病理证实的椎管内硬膜外血管脂肪瘤5例,进行回顾性分析.结果 5例均位于胸段椎管内硬膜外,硬膜受压但完整,其中上胸段2例,中胸段2例,下胸段1例.术前定位准确5例（准确率100%）,定性准确4例（准确率80.0%）.肿瘤的MR信号由脂肪和血管两部分构成,肿瘤在T1WI呈高或中低信号（与血管含量有关）,T2WI为高信号,未见血管流空影,脂肪抑制后呈低信号,增强后呈不均匀强化或明显强化.结论 MRI能清楚显示血管脂肪瘤的大小、形态、内部情况及与邻近硬膜囊的关系,对于病变有良好的定位及定性诊断价值.

The MRI Diagnosis of Spinal Epidural Angiolipomas :A Report of Five Cases

Objective To analyze the manifestations of MRI in spinal epidural angiolipomas,and to improve the diagnosis level of spinal epidural angiolipomas.Method Five surgically proved cases of spinal epidural angiolipomas were retrospectively reported.Results Five cases of angiolipomas were all spinal epidural angiolipomas,the dura mater of patiens was pressured but still complete.Among the 5 cases,2 cases of angiolipomas was in the superior thoracic level,2 cases in the middle thoracic level,and 1 case in the inferior thoracic level.The MR signals of angiolipomas were composed of the signals of adipose and blood vessels.The MR signals of angiolipomas showed hyperintensity or intermediate hypointensity on T1-weighted images（related to the density of vessels）,but there was no flow void signs on MR images.The signals of angiolipomas showed hypointensity after inhibiting the signals of adipose,and showed heterogeneous enhancement or significant enhancement after enhancing the signals of adipose.Conclusion MRI can clearly demonstrate the the size,shape,and internal situation of angiolipoma,and its relation with neighboring dural sac,so MRI has good diagnostic value in the location and identification of angiolipoma.