低场强MRI对脊柱转移瘤的诊断

MRI diagnosis of metastasis of the spine

目的 探讨脊柱转移瘤的MRI表现、诊断和鉴别诊断。材料与方法 选择134例证实的脊柱转移瘤,分别观察椎体、附件、椎间盘的破坏、局部肿块、淋巴结肿大及其他转移征像,椎管狭窄及其原因。结果 单个椎体破坏41例(30.6％),多个椎体破坏93例(69.4％)为相邻、跳跃及混合型椎体破坏。T1WI均为信号减低,T2WI信号改变可以多种多样,附件破坏64例(47.8％),局部肿块29例(21.6％),伴淋巴结肿大45(33.6％)及其他转移征象50例(37.3％),椎间盘均无破坏。结论 脊柱转移瘤有特征性的表现,注意观察椎体破坏的方式、信号、高度及椎体外其他原发灶及转移灶征象是诊断的关键。横断位扫描有利于原发灶及其它的转移灶的发现。

Objective: To investigate MRI features of metastasis of spine and differentialdiagnosis. Methods: 134 cases of proven metastasis of spine was observed: the MRI features of bony destruction, mass formation, lymph node enlargement, others metastasis signs. Results: Destruction occurred at single vertebral body was 41 cases (30. 6% ), at multiple vertebral body was 93 cases (69.3%), MRI signal of the lesion in vertebral body demonstrated decreased on T1WI and complex variation on T2WI. 64 cases(47. 8% ) showed destruction of the accessory parts. 29 cases (21.6%) showed local mass. 45 cases (33.6%) of lymph node enlargement and in 50 cases (37. 3% ) othses metastasis signs were seen. On 56 cases of suspected spine metastasis the primary cancer lesion on axial picture were found. Conclusion: The metastasis of spine demonstrate spicial MRI features. Careful observation of the shape, hight and signal of the vertebral body involved, and involvment of the accessory parts, local mass, lymph node enlargement, and others metastasis signs was useful in differential diagnosis. Axial scan is useful to find primary cancer and other metastasis.