脊髓成血管细胞瘤的MR诊断

The MR diagnosis of spinal hemangioblastomas

目的分析脊髓成血管细胞瘤的ＭＲ表现。方法１６例经手术病理证实的脊髓成血管细胞瘤患者，男６例，女１０例，年龄１５～５７岁，平均年龄３０．７岁，全部行ＭＲ检查。结果在１６例患者中，出现多发或合并有小脑成血管细胞瘤的患者有８例，共发现脊髓成血管细胞瘤２３个。发生于颈段者１４个，其中９例位于Ｃ３水平以上。发生在胸髓者９个。１６个肿瘤位于脊髓背侧，４个肿瘤于脊髓中央，位于脊髓一侧、腹侧和髓外的肿瘤各１个。肿瘤表现为长或等Ｔ１、长Ｔ２或稍长Ｔ２信号。脊髓可增粗，髓内可见囊腔形成或空洞。平扫时大部分肿瘤（１８个）与囊变或空洞混淆在一起，不易区分。脊髓空洞内可出现分隔（１０个）或无分隔（１３个）。９个肿瘤内或肿瘤周围出现血管流空影，其中８个位于脊髓的背侧。增强扫描后肿瘤明显强化，肿瘤的部位和边界显示得十分清楚。肿瘤增强的形态可分为两类：大结节（１３个）和小结节（１０个）。结论脊髓成血管细胞瘤常表现为多发的、明显强化的髓内占位。肿瘤背侧可见血管流空影，并伴有较大范围的脊髓空洞和脊髓增粗。ＭＲ扫描特别是增强扫描是评价脊髓成血管细胞瘤的最佳手段。

Objective To evaluate the MR features of spinal hemangioblastomas. Methods Sixteen patients (6 male, 10 female, age ranged from 15 to 57, mean age 30.7) with histologically proven spinal hemangioblastomas were included in this study. Results Total 23 spinal hemangioblastomas were displayed by MR studies. The tumor frequently occurred in cervical cord (14/23), usually above C3 level (9/14). The tumor commonly involved the posterior aspect of the cord (16/23). The spinal hemangioblastoma usually showed iso hypointensity on T 1WI and hyperintensity on T 2WI. The extensive cord enlargement with cyst formation or syrinx was common. On unenhanced study, the tumor may be indistinguishable from cyst or syrinx. Flow void was shown in 9 patients, and in 8 tumors on the dorsal surface of the cord or tumor. On contrast study, all tumors showed marked homogeneous enhancement with clear borders. Conclusions The spinal hemangionblastomas usually present as multiple lesions with marked contrast enhancement. The extensive cord enlargement and flow void in the dosal part of the tumors are common in these patients. MR study, especially the contrast enhancement T 1WI, can clearly demonstrate the tumor.