33例脊柱转移瘤的高场强磁共振成像分析

Analysis of image of vertebral metastasis in high field MRI:Report of 33 cases

目的 探讨高场强下脊椎转移瘤的磁共振特点及其应用价值。方法 采用 Philips Medical Systems.Inc Eclipse超导型 (1.5 T)磁共振机 ,扫描序列使用 FSE (Fast spin echo) T1 、 T2 加权 ,扫描方位包括矢状位(S)、冠状位 (C)、横断位 (T)。 33例脊椎转移瘤病例皆经手术病理、临床资料或其它影像学检查证实。结果 33例中共发现脊椎转移瘤 15 1个 ,颈椎 5个 (3.3% ) ,胸椎 79个 (5 2 .3% ) ,腰椎 4 4个 (2 9.1% ) ,骶椎 2 3个 (15 .2 % )。T1 加权图像转移瘤以低信号为主 ,T2 加权图像上病变椎体可表现为四种类型 ,高信号 5例 (15 % ) ,高低混杂信号13例 (4 0 % ) ,等信号 8例 (2 4 % ) ,低信号 7例 (2 1% )。结论 高场强磁共振是脊椎转移瘤可靠的影像诊断手段 ,并可对其转移途径、生长方式、累及范围进行评价。

Objective To investigate the image characteristics of vertebral metastasis in high field MR scanner and to evaluate its application value.Methods Conventional T 1 and T 2 weighted images were performed on a superconductive MR scanner(Philips Medical Systems.Inc Eclipse,1.5T)with Fast Spin Echo(FSE)in 33 patients with vertebral metastasis whose scaning position include sagitta,coronal and traverse.Final diagnosis was determined by surgical and histopathological findings or other imaging methods.Results One hundred and forty-eight metastases were found in 33 patients:Five(3.3%) in cervical vertebrae;79 (52.3%) in thorax vertebrae;44(29.1%)in lumbar vertebrae;23(15.2%)in sacral.Almost all the metastases were hypointense or isointense on T 1-weighted images.On T 2-weighted images,the signal intensity can be classed into four grades:hyperintense 15%(5/33),heterogeneous-intense 40%(13/33),isointense 24%(8/33),hypointense 21%(7/33).Conclusion High field MRI is a reliable diagnostic tool for vertebral metastasis and can be used to evaluate metastatic route,growth pattern and intraspinal involvement.