单椎骨病变MRI诊断的探讨

MRI Diagnosis of Single Vertebral Lesions

目的 分析单个椎骨病变的MRI表现 ,探讨MRI对其诊断的影像学特征。材料与方法 采用美国GE公司 1.5TMR成像仪 ,扫描序列包括 :矢状位 :T1WI、T2 WI ,增强后 :矢状位、冠状位、横轴位T1WI。选择 2 4例经术后病理和临床证实的脊柱肿瘤、脊柱结核以及嗜酸性肉芽肿等 ,分别观察椎体、椎间盘、附件病变的情况 ,脓肿或软组织肿块的大小与有无 ,MRI信号的变化。结果 脊柱转移性肿瘤中常可见附件的破坏 ,椎旁软组织肿块较为局限 ,硬膜囊和脊髓受压的原因为变形的椎体和硬膜囊后方的硬膜外转移。脊柱结核时椎体破坏位置靠近椎间盘 ,脓肿多位于椎体前缘 ,附件未见破坏。脊柱良性肿瘤有较为典型的MRI表现 ,原发脊柱的恶性肿瘤与脊柱单椎骨转移瘤较难鉴别。嗜酸性肉芽肿多发生于青少年 ,且椎体呈楔形改变。结论 MRI对单椎骨病变的定性诊断有一定的价值。

Objective To evaluate MRI in diagnosing single vertebral lesions.Materials and Methods Twenty four cases with pathologically or clinically proved single vertebral lesions, including tumor, tuberculosis and eosinophilic granuloma, were collected in this study. Plain and Gd DTPA enhanced MR scanning, including sagital T 1WI and T 2WI before contrasted and axial, coronal, sagital T 1WI after contrated, were performed in all patients on a 1.5T MR unit (GE Signa Advantage).Results Destroyed accessory parts were a common finding in metastatic tumors, with localized small paraspinal mass. Compression of the thecal sac and cord was due to deformed vertebral body and extradural metastatic lesions. In case with tuberculosis of spine, the destruction of the vertebral body was usually adjacent to the disc, the abscess was large and was located at anterior margin of the vertebral body. Hemangiomas had typical MRI appearance. Most osteoblastomas involved the posterior vertebral structure. MR findings were not helpful for differentiating primary malignancy from metastases. In eosinophilic granuloma, to which children of 3～12 years old were particularly subject, the vertebral body became wedge shaped.Conclusion MR imaging has certain value for the qualitative diagnosis of single vertebral lesions.