MRI增强检查在脊柱病变中的诊断价值

The Value of Gd-DTPA Enhanced MR Imaging in Diagnosing Spinal Lesions

目的：讨论不同种类脊柱病变的ＭＲＩ表现及Ｇｄ－ＤＴＰＡ增强检查在脊柱病变中的意义。材料与方法：研究脊柱病变５７例，均行矢状位、轴位Ｔ１ＷＩ、Ｔ２ＷＩ及增强后Ｔ１ＷＩ扫描，其中１２例增强后采用脂肪抑制技术（ＣＨＥＳＳ法）扫描。结果：（１）不同的脊柱病变ＭＲＩ表现不同；（２）在增强后脂肪抑制组及未抑制组，显示脊柱病变与正常骨髓分界最清晰的序列中增强后Ｔ１ＷＩ分别占５１．１％、９２．７％；（３）所有病例在显示椎旁肿块与周围关系最明确的序列中增强后Ｔ１ＷＩ占８３．８％。结论：（１）增强检查对脊柱病变的诊断与鉴别诊断有重要价值；（２）它有利于显示椎旁肿块与椎管内结构的关系；

Objective: To study the characteristic demonstrations of pre and post enhanced MR imaging in different kind of spinal lesions. Toevaluate the diagnostic value of Gd DTPA enhanced MR imaging for spinal lesions.Materials and Methods:Fifty seven cases with spinal lesions were studied with a 1.5T MR unit (GE Signa Advantage). T 1WI, T 2WI and enhanced T 1WI in both sagittal and axial plane were performed in all 57 cases, and fat suppression technique (CHESS) after contrast administered was also used in 12 of them.Results:(1)Different spinal lesions had different appearances on the plain and enhanced scans. (2)After enhanced, some lesions were sharply delineated, and T 1WI scan revealed 92.7% in the group using CHESS and 51.1% in the group not using CHESS. (3)Of all sequences which demonstrated the paraspinal mass best, enhanced T 1WI held 83.8%.Conclusion: (1)Enhanced MR is helpful in diagnosing and differentiating the spinal lesions. (2)Enhanced T 1WI is the most useful sequence for visualizing the paraspinal mass. (3)Plain scan of T 1WI and T 2WI, together with enhanced T 1WI using CHESS, seems to be the first choice in diagnosing spinal lesions.