脊椎及椎管内血管瘤的MRI及X线平片诊断

MRI and Plain Film Diagnosis of Spinal and Intravertebral Hemangioma

目的：讨论脊椎及椎管内血管瘤的平片及ＭＲＩ特征。材料与方法：经手术和病理证实的脊椎及椎管内血管瘤共６例。ＭＲＩ检查采用ＡＳＭ－０６０超导型ＭＲ机，ＳＥ序列，均作平扫及增强扫描。平片为局部脊柱正侧位点片。结果：６例均发生于胸段，分３类：（１）椎体血管瘤累及硬膜外；（２）椎板血管瘤累及硬膜外；（３）单纯硬膜外血管瘤。血管瘤的ＭＲＩ表现：Ｔ１加权像呈低信号，Ｔ２加权像呈高信号，增强后明显强化。其平片特征：累及椎体者椎体呈栅栏状改变。结论：ＭＲＩ具有良好的软组织分辨力，可清楚显示脊椎及椎管内血管瘤的大小、范围，以及椎体、椎板的改变。平片不能直接显示血管瘤本身，但平片的椎体栅栏状改变可帮助诊断累及椎体之血管瘤。

Objective: To study the MRI and Xra y features of the spinal and intravertebral hemangioma. Materials and Methods:Plain and contrastenhanced MR scan ning (ASM 060 superconductive MR unit) using SE sequence was performed in 6 case s with surgically and pathologically proved spinal and intravertebral hemangioma s. Spot films of local spinal column in both AP and lateral position were also t aken. Results:In all 6 cases, the tumors were localized in thora cic spine and could be divided into three types according to its location: (1) v ertebral body hemangioma; (2) vertebral lamina hemangioma; (3) pure extramedulla ry hemangioma. The hemangioma showed low signal on T1WI and high signal on T 2WI, and was enhanced markedly after contrast injection. On Xray film, the inv olved vertebral body had a palisadelike appearance. Conclusion: Because of its superior resolution for soft ti ssue, MRI can well demonstrate the size and extent of intraspinal extramedullary hemangioma, as well as the changes of vertebral body and lamina. The palisade like appearance of vertebral body on plain film is a useful sign leading to the diagnosis of hemangioma.