脊柱转移瘤的低场MRI诊断——附33例报告

Low-field Intensity MRI Diagnosis of Spine Metastasis 33 Cases Report

目的 :探讨低场磁共振成像 (MRI)对脊柱转移瘤的诊断价值。方法 :选择经临床病理证实的 33例脊柱转移瘤作为研究对象 ,常规行T1WI、T2 WI矢状位扫描 ,必要时行横断、冠状位扫描或增强扫描。结果 :33例中 ,多椎体转移 2 7例 ( 81 8% ) ,病灶大都呈跳跃式分布 ( 2 5/ 2 7,92 5% ) ,不累及椎间盘 ;单椎体转移 6例 ( 18 2 % )。病变侵及椎体全部或部分受累 ,部分受累者多数边界清楚 ,呈结节状或不规则形。在T1WI为低信号 ,T2 WI为高信号。合并病理骨折 14例 ,计 2 7个椎体 ;椎体破坏伴附件破坏 16例 ;伴椎体旁软组织肿块 9例。注射Gd DTPA后呈中等度增强或明显增强。结论 :低场MRI对脊柱转移瘤的诊断具有较高的敏感性。

Objective To study the value of low feild MR imaging in diagnosing spine metastasis.Methods Clinically or pathologically proved spine metastatse (33 cases)were applied to this study.The routine MR imaging sagital T 1 weighted and T 2 weighted images were obtained in each patient,and axial,coronal or enchancement images were also obtained in some patients necessarily.Results In 33 cases,the multiple vertebral body metastases were found in 27 cases (81.8%) and these lesions usually appeared “jump sign” (25/27,92.5%) and intervertebral discs were uaually not involed,the single vertebral body metastases were found in 6 cases (18.2%).The spine metastases could be invaded part or all of vertebral body.Most lesions invading part of the vertebral body showed well define margin,nodular or irregular shape.The lesions appeared low signal intensity on T 1 weighted images and high signal intensity on T 2 weighted images.The spine metastases combined with vertebral body compression fracture was seen in 14 cases (27 vertebral bodies),with vertebral body and annex to vertebral body were invaded in 16,with the mass lesion in paravertebral soft tissue in 9.On the past contrast images,the lesions of spine metastases were enhanced moderately or markedly with intravenous injection of Gd DTPA.Conclusion The spine metastases can be diagnosed with low field MRI accurately and sensitively.