脊柱淋巴瘤的CT、MRI表现

CT and MRI of spinal lymphoma

目的探讨脊柱淋巴瘤的影像学表现,评价CT、MRI在其诊断中的价值。方法16例病理证实的脊柱淋巴瘤患者接受CT检查,12例接受MRI检查。结果16例患者年龄8～63岁,共65个脊椎受累,颈、胸、腰骶椎分别为15、22、28个。11例患者病灶为多发、连续性,其中3例伴跳跃性分布。CT示病灶为溶骨、成骨、混合性骨质破坏及骨质破坏不明显各13、27、10、15个。MRI病灶以T1WI低或等信号、T2WI等和稍高信号为主。CT及MRI均显示椎管内侵犯范围较椎体破坏范围广泛的特点。结论CT病灶呈多种形式骨质破坏,MRI以T1WI低或等、T2WI等和稍高信号为主,病灶易侵及椎旁或硬膜外间隙,沿椎管呈纵向分布;MRI对显示病灶较CT更清晰、敏感,部分病灶MRI可见信号异常而CT无明显骨质改变。

Objective To discuss the CT and MR imaging appearances and diagnostic value of spinal lymphoma.Methods Sixteen patients with pathologically proved spinal lymphoma（aged 8 to 63 years）were retrospectively reviewed.CT were performed in all 16 patients,and MRwere performed in 12 patients.Results Totally 65 vertebrae（cervical 15,thoracic 22,lumbar and sacrum 28）were involved.Multiple lesions were found in 11 patients.The characters of these lesions were osteolytic,osteogenic or mixed on CT.The signal intensity was hypo or iso on T1WI and iso or slightly hyper on T2WI.The extradural involvements were more extensive than that of the vertebrae both on CT and MR images.Conclusion Lesions of spinal lymphoma usually demonstrate various bone destructions on CT,and hypo or iso intensity on T1WI as well as iso or slightly hyper intensity on T2WI,tending to involve paraspinal or extradural space,and longitudinal involvements are often seen along the vertebral canal.MRI is more sensitive than CT in detecting spinal lymphoma lesions.