椎管内血管畸形的MRI诊断

MRI Diagnosis of Intraspinal Canal Vascular Malformation

目的:评价MRI对椎管内血管畸形的诊断价值。方法:35例临床疑诊脊髓病变或椎间盘突出的患者,分别行MR平扫、增强扫描检查,其中18例行3D-CISS、15例行MR血管成像(CE-MRA)检查。所有影像资料和手术病理结果均进行了回顾性分析。结果:33例动静脉畸形患者中,30例出现典型血管流空征象,3例未见明显畸形血管流空影;2例海绵状血管瘤均被误诊,其中1例伴出血和血栓形成。结论:MR平扫即可诊断具典型血管流空信号的椎管内动静脉畸形和继发脊髓病变,3D-CISS和CE-MRA有助于畸形血管的显示;海绵状血管瘤继发出血,易误诊为肿瘤。

Objective： To evaluate the role of MRI in the diagnosis of intraspinal canal vascular malformation. Methods：Both MR scanning without and with contrast administration were performed in 35 patients with clinically suspected spinal cord lesions or inter-vertebral disc protrusion. 3D-CISS and CE-MRA were studied in 18 patients and 15 patients respectively. Imaging and pathology findings were retrospectively analyzed. Results： Of the 33 patients with arteriovenous malformation, 30 patients had typical flow void effect in abnormal vessels, the other 3 patients didn＇t show obvious flow void effect. 2 cases of cavernous angioma were misdiagnosed,one of them had subacute hemorrhage and thrombosis. Conclusion： Arteriovenous malformation of intrasplnal canal with typical flow void effect and its secondary spinal lesion can be diagnosed by plain MRI, 3D-CISS and CE-MRA are useful in displaying deformed vessels. Secondary hemorrhage is commonly coexisted with intraspinal canal cavernous hemangioma,which is easily to be misdiagnosed as intraspinal canal neoplasm.