MRI对良恶性椎体疾病的鉴别诊断

Differentiation Between Benign and Malignant Vertebral Diseases with MRI

目的：提出良恶性椎体疾病的鉴别要点。材料和方法：本组１０６例，其中４０例恶性椎体病变和６６例良性椎体病变，经病理、临床及随访证实。设备采用美国ＧＥ公司１．５Ｔｓｉｇｎａ成像仪。常规行自旋回波Ｔ１加权，快速自旋回波Ｔ２加权，梯度回波Ｔ２＊加权，矩阵２５６×１９２，层厚４．０ｍｍ，间隔１．０ｍｍ。结果：晕征（３０％）、靶征（２７．５％）Ｔ１ＷＩ椎间盘信号增高（７．５％）、跳跃征（４０％）、椎弓根破坏（８０％）、椎旁软组织肿物（４０％），常见于恶性椎体病变。Ｔ１ＷＩ椎体信号增高（４．５５％）、平行于终板的带状异常信号（１２．１２％）、椎体碎裂并椎间盘突出（或脱出）（１９．７１％）、椎间盘破坏（２１．２１％）、椎间隙变窄（３３．３３％）、常见于良性椎体病变。椎基底静脉消失征不能作为鉴别诊断的要点。结论：磁共振椎体成像征象多。ＭＲＩ用于鉴别良恶性椎体疾病具有重要作用。

Purpose:Suggesting the distinguishing signs of benign and malignant vertebral diseases.Materials and Methods:This group consisted of 106 cases including 40 malignant vertebral diseases and 66 benign ones.All cases were confirmed by histology,clinical diagnosis and follow up.MR studies were performed on 1.5T signa GE Medical System with SE T1 WI,FSE T2WI,GR T2WI.All sequenees used a 256×192 matrix,a section thickness of 4mm with a skip gap of 1mm.Results:The following signs were frequently observed in malignant vertebral diseases:halo sign(30%),target sign (27.5%),intense high signal of intervertebral disk on T1 WI (7.5%),leapping sign (40%),pedicle destruction (80%),and paravertebral masses(40%),The other signs were often found with benign vertebral diseases:increased vertebral signal intensity on T1 WI(4.55%),bandlike focal abnormal signal intensities paralled to end plates(12.12%),fragmentation of vertebral body with disk protrusion (or extrusion)(19.70%),disk destruction (21.21%),and narrowing of disk space(33.3%).The basivertebral vein disappearance could not be used as a differential sign. Conclusion:Many signs of vertebral diseases could be presented by MRI which in tern. Played an important role in differentiating benign and malignant vertebral diseases.