肥厚性硬脊膜炎的MRI表现

目的 观察肥厚性硬脊膜炎(HSP)的MRI表现。方法 回顾性分析12例HSP患者的影像资料,其中7例经临床及影像学检查确诊,5例经病理证实。结果 12例HSP患者中,MR显示11例位于颈胸椎的硬脊膜增厚范围为10个以上椎体水平,1例位于胸腰椎的硬脊膜增厚累及范围为5个椎体水平;6例表现为背侧、2例为腹侧硬膜增厚,4例背侧及腹侧硬膜均增厚。2例增厚的硬膜呈结节样,1例合并硬膜外肿物形成,5例合并硬膜囊背侧脂肪增多。增厚的硬膜T2WI均呈低信号,4例T1WI呈等信号,8例T1WI呈低信号。10例增强扫描患者中,4例明显强化,1例中等强化,5例未见强化。结论 HSP以颈胸椎背侧或腹侧硬膜广泛增厚为特点,部分合并硬膜外脂肪增多;增厚的硬膜呈结节样或条带状,少数可合并硬膜外肿物形成;T2WI呈特征性低信号。

MRI appearance of hypertrophic spinal pachymeningitis

Objective To explore MRI features of hypertrophic spinal pachymeningitis (HSP). Methods Imaging data of 12 patients with HSP were retrospectively analyzed. There were 7 cases confirmed by clinical and imaging appearance and 5 cases confirmed by pathological diagnosis. Results Eleven cases located in cervical and thoracic vertebrae showed the thickened dura involving more than 10 vertebral levels,while one case among 12 cases located in thoracolumbar spine involved 5 vertebral levels on MRI scan. There were 6 cases of dorsal spinal dural thicken, 2 cases of ventral spinal dural thicken and 4 cases of dorsal and ventral spinal dural thicken. The thicken spinal dural displayed as node sample in 2 cases. One case combined with epidural mass formation, and 5 cases combined with extra dural fat over growth. The thicken dura showed low signal in all of 12 cases on T2WI, while the equal signals were found in 4 cases and the low signals were found in 8 cases on T1WI. Among 10 cases underwent enhanced CT scan, there were 4 cases of obvious enhancement, 1 case of moderate enhancement and 5 cases without enhancement. Conclusion The dorsal or ventral dura thicken were characteristics of HSP, part of HSP with epidural fat overgrowth. The thicken dura mater showed nodular or banded shape, and minority combined with epidural mass formation. HSP showed characteristic low signal on T2WI.