磁共振诊断脊柱转移瘤的分析

目的通过40例MRI诊断脊柱转移瘤的分析,探讨MRI对其诊断的优越性。方法受检者均取仰卧位。平扫:矢状位T1WI FSE-430/18,T2WI FSE-4500/108,STIR序列IRFSE-2400(80)/30,横断位CBASS 3D-8.3/4.1,OB4.0 mm,FOV250-350,反转角度(FA)45°～90°,矩阵256×256。增强扫描:注射钆喷替酸葡甲胺(Gd-DTPA)0.2 ml/kg。结果转移部位:颈椎1例,胸椎8例,腰椎7例,骶椎5例,胸腰椎12例,腰骶椎2例,胸腰骶椎5例。单纯椎体转移12例,椎体伴附件转移12例,椎体转移伴病理骨折15例,椎管与脊髓侵犯及软组织块影13例。溶骨型转移T1WI呈低信号,T2WI呈高信号,脂肪抑制序列呈高信号。硬化型转移T1WI和T2WI均呈低信号,STIR序列呈低信号。混合型转移呈不均质或弥漫型高信号。注射Gd-DTPA可呈中等度增强或明显增强。结论 MRI诊断脊柱转移瘤有极高的敏感性和更大的扫描视野,容易发现附件侵犯与软组织块。

An analysis on MRI diagnosis of spinal metastasis

Objective To evaluate MRI diagnosis of spinal metastasis by analysis of 40 cases of spinal metastasis.Methods The patients were all at supine position and scanned routinely as follow parameters： T1WI FSE-430/18,T2WI FSE-4500/108,STIR： IRFSE-2400（80）/30,CBASS 3D-8.3/4.1,OB 4.0 mm,FOV 250-350;（FA）45°-90°;Matrix： 256×256.The enhancement Scan was carried out at Gd-DTPA 0.2 ml/kg.Results The diagnosis of spinal metastasis was made including one case of cervical,8 cases of thoracic vertebra,7 case in lumbar,5 cases of sacralization vertebral,12 cases in thoracolumbar,2 cases in the lumbosacral vertebral,5 cases in thoracic vertebra lumbosacral,12 cases with single vertebral body metastase,12 cases appeared annes to vertebral body invaded,15 vertebral bodies appeared pathologic fracture,13 cases with sedation and spinal cord invation and appeared mass in soft tissue.The low signal intensity on T1WI,high signal intensity and high signal intensity on FSE has been detected in spinal osteolytic metastasis.MRI had detected low signal intensity on T1WI and T2WI,and also low signal intensity on STIR in sclerosis metastasis.In multi metastasis,mixture signal intensity or diffuse high signal intensity has been detected.Contrasted with GD-DIPA,the mass show moderately or strongly enhanced.Conclusion MRI diagnosis spinal metastasis in an extremely high sensitivity and larger scan vision.