椎管内血管性病变MRI误诊分析

Analysis of MRI Misdiagnosis to the Intraspinal Canal Vascular Diseases

目的总结椎管内不典型血管性病变的MRI表现,以提高对该病的认识。资料与方法回顾性分析4例MR误诊、经手术病理证实的椎管内血管性病变的MRI表现,探讨误诊原因。结果2例椎管内硬膜外动静脉畸形MRI分别表现为等T1,等T2和短T1、长T2信号,均单纯报告为血肿。2例海绵状血管瘤,1例表现为较均匀等T1、长T2信号,增强后见明显均匀强化误诊为神经源性肿瘤;另1例呈短T1、短T2信号而误诊为黑色素瘤。结论椎管内血管性病变有时仅表现为局限性出血的征象或出现类似神经源性肿瘤的征象,仔细分析和观察病灶的位置、信号特点、增强表现,并结合临床有助于提高诊断准确性。

Objective To discuss the reason of MRI misdiagnosis in the intraspinal canal vascular diseases in order to make a further understanding, Materials and Methods Both MRI and pathological findings in 4 cases with atypical intraspinal canal vascular diseases were retrospectively analyzed, Results 2 extradural AVM which had hypo or isointensity on T1W and iso or hyperintensity on T2W were misdiagnosed as hematoma, 2 cavernous hemangiomas were misiagnosed as melanoma and neurogenic neoplasm which had hyperintensity on T1, T2 and isointensity on TIW, hyperintensity on T2W respectively. Conclusion Sometimes intraspinal canal vascular diseases are appeared as the same MR appearance of haematoma and neurogealc tumor, analyzing the location, intensity character, enhancement and clinical manifestation of lesion are helpful for correct diagnosis.