髓外硬膜外肿瘤的MRI诊断 [附20例分析)

目的探讨椎管硬膜外肿瘤的MRI表现特点及鉴别诊断.材料与方法分析20例硬膜外肿瘤的MRI影像资料,结合手术病理讨论各种肿瘤的MRI特点.结果本组转移瘤7例,5例呈等T1和略长T2信号,增强扫描均呈明显增强.2例呈长T1长T2信号,6例伴椎体骨质长T1长T2信号,增强扫描均呈明显增强.5例淋巴瘤中3例T1WI呈等信号,2例为略低信号,1例T2WI为高信号,4例为等信号,1例伴胸4椎体骨质内长T1短T2信号,增强扫描3例呈均匀性增强.黑色素瘤2例呈短T1短T2信号,可广泛侵及硬膜.海绵状血管瘤可与神经源性肿瘤的MRI表现相似.胆脂瘤为不规则形长T1长T2信号,肿物充填于椎管内,对椎体骨质有压迫性破坏.脊膜瘤2例呈等T1等T2信号,呈明显均匀性增强.恶性纤维组织细胞瘤呈长T1长T2信号.骨髓瘤可见椎体及椎管内长T1长T2信号,有明显增强.结论椎管内硬膜外肿瘤种类繁多,但以恶性肿瘤最多,其中以淋巴瘤,转移瘤占大多数.恶性纤维组织细胞瘤,胆脂瘤,有时与淋巴瘤,转移瘤MRI表现相仿.而脊膜瘤,黑色素瘤,神经源性肿瘤也可有相类似的MRI表现.因此诊断中应提高警惕,全面考虑.

MRI Diagnosis of Epidural Extramedullary Tumor of the Spinal Canal (An Analysis of 20 Cases)

Purpose: To explore the MRI features and differential diagnosis of epidural extralmedullary tumor. Materials and Methods: MRI manifestation of 20 cases of epidural extramedullary tumor confirmed by surgery and patholog were retrospectively reviewed and anal ysed. Results: 7 cases were metastasis tumor showed iso-or hypointensity on T_1WI, iso-or hyperintensity on T_2WI, 6 cases with vertebral bodies involved. After injection contrast medium, all cases showed obvious enhancement. 5 cases were lymphadenoma, 3 cases showed isointensity, 2 cases showed hypointensity on T_1WI. On T_2WI, 4 cases showed hyperintensity, 1 case with vertebral involved and 2 cases medlanoma showed shorter T_1 and shorter T_2 signal with obvious enhancement The MRI features of cavemous angioma was similar to neu rogenic tumor, which was rare case. Cholesteatoma showed longer T_1 longer T_2 signal intensity. 2 cases meningloma showed isointensity in T_1WI and T_2WI, with homogenous enhancement. 1 case myeloma showed longer T_1 and longer T_2 signal intensity, with multiple vertebral involved. Conclusion: Most of the extradural space tumor are malignant tumors, in which, metastasis tiumor and lymphadenoma are com mon. The MRI feastures of cholesteatoma. myeloma are similar to metastasis and lymphadenoma, as well as the MRI features of menin gioma. melanoma and neurogenic tumor are similar. We should pay attention to the differential diagnosis.