椎管内硬膜外海绵状血管瘤的影像诊断

目的探讨椎管内硬膜外海绵状血管瘤的CT、MRI表现及诊断价值。方法回顾性分析经病理证实的5例椎管内硬膜外海绵状血管瘤的MRI（n=5）和CT（n=4）表现。结果5例患者中，肿瘤位于胸段椎管内4例，腰段1例。均位于硬膜外间隙，沿椎管长轴生长并延及椎旁。其中脊髓背侧3例，可见环绕脊髓生长，呈钳状；左后侧1例，右后侧1例，沿相邻椎间孔向外生长；梭形3例，哑铃形1例，1例一端尖锐，呈鼠尾状。5例肿瘤MRIT2WI呈均匀高信号4例，不均匀稍高信号1例，增强扫描均呈明显强化。相邻的骨侵蚀（n=5）和椎间的神经孔扩大（rt=4）多见。结论椎管内硬膜外海绵状血管瘤有其特征性MRI、CT表现，有助于术前精确定位及初步诊断。

Imaging diagnosis of spinal epidural cavernous hemangiomas

Objective To investigate the manifestation of spinal epidural cavernous hemangioma and its diagnosis by CT and MRI. Methods Clinical data from five patients who were pathologically diagnosed with spinal epidural cavern- ous hemangioma （ n = 5 for MRI and n = 4 for CT） were retrospectively analyzed. Results Four out of five patients bear the tumor at the thoracic level, while another one at the lumbosaeral section. The mass was located in the epidural space and grew along the spinal canal to the paravertebral part in all cases. There were three cases at the posterior part where the mass encircled the spinal cord and showed a ＂clamp＂ shape; one case at the right posterior part and another case at the left posterior part where the mass grew excentrieally along the adjacent intervertebral orifices. Three cases were spin- dle - shaped, one case dumbbell - shaped, and one case shaped like the tail of a rat, with one sharp - pointed end. A- mong five cases were four with uniform high signal intensity on T2 - weighted images and one with non - uniform slightly high signal intensity, which were remarkably strengthened after enhanced scanning. Adjacent bony erosion （ n = 5 ） and intervertebral neural foraminal widening （n = 4） were common. Conclusion The characteristic MRI and CT images of spinal epidural cavernous hemangioma are useful to provide accurate localization and primary diagnosis.