硬膜外脊膜瘤的影像学表现

目的 观察扁平形硬膜外脊膜瘤的影像学表现。方法 回顾性分析8例经手术病理证实的扁平形硬膜外脊膜瘤的影像学表现表现，并进行文献复习。结果 7例硬膜外脊膜瘤位于颈椎管，1例位于胸椎管，累及2~4个椎体节段；8例病灶均呈扁平形、以增厚的硬膜为基底，伴硬膜外肿块形成；5例肿瘤经椎间孔向硬膜外延伸、相应水平椎间孔扩大；椎管均均匀变窄，1例伴脊髓水肿，1例伴脊髓变性。CT显示病灶呈等密度，6例硬膜可见条片状钙化。MRI显示病灶于轴位图像上均呈半环形，包绕脊髓，T1WI上呈等（n=5）或低（n=3）信号，T2WI上呈等（n=3）或低信号（n=5）；增强后呈中等（n=2）或明显（n=6）强化，其中7例强化均匀，1例不均匀。结论 扁平形硬膜外脊膜瘤好发于颈椎管，可累及多个椎体节段，以硬膜增厚、钙化并硬膜外肿块形成为其特征。

Imaging findings of spinal epidural meningioma

Objective To observe the imaging characteristics of en-plaque epidural meningiomas. Methods Eight cases of surgically and pathologically confirmed en-plaque epidural meningioma were analyzed, and the related literatures were reviewed. Results Seven of 8 epidural meningiomas located in the cervical spinal canal, while only one located in the thoracic spinal canal, extended 2-4 vertebral levels. The lesions showed as epidural masses formation based on the thickened dura mater. Five tumors extended to the outer part of spinal canal through intervertebral foramen with corresponding intervertebral foramen enlarged. Spinal canal was evenly narrowed, one case complicated with spinal cord edema and another one with spinal cord degeneration. The tumors were isointense, and 6 cases with dural flake calcification on CT images. On MRI, 5 cases showed isointense signal and 3 showed hypointense signal on T1WI. Three tumors showed isointense and five tumors showed hypointense signal on T2WI. Two tumors showed moderate enhancement and 6 showed significant enhancement on contrast-enhanced T1WI. Seven tumors showed homogeneous and one showed heterogeneous enhancement. Conclusion En-plaque epidural meningioma mainly located in cervical spine, characterized as thickened dural mater with epidural mass formation and calcification.