肥厚性硬膜炎的MRI影像表现及鉴别诊断

目的探讨肥厚性硬膜炎(HP)的磁共振成像(magnetic resonance imaging,MRI)表现,以提高对肥厚性硬膜炎的诊断水平。材料与方法回顾性分析2013年7月至2016年6月于我院就诊的7例经临床及病理证实的肥厚性硬膜炎(hypertropic pachymeningitis,HP)患者的MRI影像资料,总结其影像特点。结果 7例肥厚性硬膜炎,2例累及胸椎硬脊膜,5例累及多部位硬脑膜,均表现为硬膜不均匀性增厚,6例增厚的硬膜在T1WI呈等信号,T2WI呈低信号,其中2例T2WI低信号边缘可见条带状高信号影环绕;仅1例增厚的硬膜表现为T1WI呈稍低信号,T2WI呈稍高信号;增强后7例增厚的硬脑(脊)膜均呈明显强化,3例伴有脑实质或脊髓受累,软脑(脊)膜异常强化。结论 HP以硬脑(脊)膜广泛性不均匀增厚为特点,T2WI多呈低信号,明显强化,可伴有软脑(脊)膜、脑实质或脊髓受累。

MR imaging findings and differential MRI diagnosis of hypertropic pachymeningitis

Objective:To investigate MR imaging ifndings of hypertropic pachymeningitis (HP) and improve the diagnostic accuracy of HP.Materials and Methods:We retrospectively analyzed MRI data of 7 patients with HP conifrmed by clinic and pathology between July 2013 to June 2016 in our hospital. The characteristics of MRI were summarized. Results:In 7 cases of HP, 2 cases involved spinal dura matter, and 5 cases involved multiple cerebral dura matter. All 7 cases showed dural thickening. 6 cases showed isointense on T1WI and hypointense on T2WI, 2 cases of them showed hyperintense in the edge on T2WI. Only 1 case showed hypo-intensity signal on T1WI and hyperintense on T2WI. The thickening dura matter of 7 cases showed obvious enhancement. Three cases involved cerebral parenchyma or spinal cord, and abnormal enhancement of pia matter could be found.Conclusions:HP is characterized by extensive and uneven thickening of dura matter, which shows hypointense on T2WI and obvious enhancement, and may accompany with involvement of pia matter, cerebral parenchyma or spinal cord.