188例脊柱转移瘤磁共振成像分析

Analysis of MR Imaging (MRI) in 188 Patients with Spinal Metastasis

[目的]分析188例脊柱转移瘤的MR表现，探讨其转移途径、生长方式和MRI诊断价值。[方法]188例脊柱转移瘤患者，均有脊柱病变区或原发肿瘤的组织学证实。MR成像采用自旋回波序列，所有病例作了T1加权成像、质子密度成像和T2加权成像，49例作了静脉注射Gd－DTPA后T1加权成像。[结果]188例共检出椎体转移756只，其中598只椎体呈现信号／形态异常，158只仅呈现信号异常。96例伴附件异常，108例体椎旁软组织肿块，121例伴椎管内侵犯。病变椎体的基本信号组合（与正常椎体相比）为T1加权像低信号和T2加权像高信号。增强后T1加权像可掩盖其原T1加权像上低信号病灶，但对椎管内侵犯程度和椎体病灶活跃部位的显示更为清晰。[结论]MR成像是脊柱转移瘤最可靠的诊断方法并可评判其转移途径、生长方式和累及范围。

[Purpose]To analysis MRI findings in 188 patients with spinal metastasis in order to investigate their metastaic source ,growth pattem and MRI value. [Methods]All 188 cases with spinal metastasis had histology proved. MR imaging was perfromed with Spin-Echo pulsc sequences.T1-weighted images.proton density impes and T2-weighted images were performed in all 188 cases and T1-weighted images after intravenous injection of Gd-DTPA were performed in 49 cases. [Results]MR imaging presented abnormal in 756 vertebral bodies in all 188 cases. Both signa-abnomal and morphologic-abnormal occured in 598 bodies of them, with only signal-ahnormal in 159 bodies. Additionally, attachment abnormal was showed in 96 cases, paravertebral mass in 108 cases and intraspinal involvement in 121 cases. The abnorml signals of spinal metastasis (related to normal vertebral bodies) included low-signal on T1-weighted images and high-signal on T2-weighted images. Enhanced MR images may obscure the lesions with low-signal intensity of T1-weighted images but well demonstrate the extent of intraspial invovement and the active lesions of vertebral bodies. [Conclusion]MR imaging is not only one of the most reliable methods for the diagnosis of spinal metatasis but also can evaluate metastatic source, growth patten and intraspinal involvement.