髓外硬膜外肿瘤的MRI诊断分析

MRI Diagnosis of Extramedullary Epidural Tumors

目的总结髓外硬膜外肿瘤的MRI影像学特点。方法收集我院收治的接受MRI检查且经手术病理证实的42例髓外硬膜外肿瘤患者,回顾性分析其MRI表现特点。结果转移瘤MRI可见长T1、长T2异常信号,抑脂序列高信号,增强扫描中度或明显强化;cobb综合征表现为T1WI等信号,T2WI稍高信号,抑脂序列明显高信号,增强扫描附件、椎体、椎管内病灶不均匀强化,病灶内有迂回、流空血管影;淋巴瘤表现为T1WI等信号或低信号,T2WI高信号,增强扫描明显、均匀强化,有"围管"征;骨髓瘤呈长T1、长T2异常信号,抑脂序列呈高信号;骨肉瘤T1WI呈不均匀低信号,T2WI呈不均匀高信号,增强扫描明显强化;神经源性肿瘤MRI T1WI呈等信号,T2WI略高信号,脊髓受压移位明显,分界清晰;恶性小圆细胞瘤T1WI呈等高信号,T2WI呈等脊髓信号,病灶中心可见小囊状T1、T2信号,增强呈明显均匀强化。结论 MRI信号、周围软组织改变、增强扫描强化程度均可作为髓外硬膜外肿瘤诊断的重要参考依据。

Objective To summarize the MRI findings of extramedullary epidural tumors. Methods Forty-two patients with extramedullary epidural tumors confirmed by surgery and pathology who underwent MRI examination in our hospital were collected. The MRI findings were retrospectively analyzed.Results MRI of metastasis tumors showed long T1 and T2 abnormal signal, high signal on anti-fat sequence, enhanced scan in moderate or obvious enhancement. MRI of Cobb syndrome showed equal signal on T1WI, slightly higher signal on T2WI and obviously high signal on anti-fat T2WI. Enhanced scan showed that there was inhomogeneous enhancement in adnexa, vertebrae and spinal lesions. There were circuitous and flow void vascular shadows. MRI of lymphoma showed equal or low signal and high signal on T2WI. Enhanced scan showed obvious and homogeneous enhancement, with periductal sign; MRI of myeloma showed long T1 and long T2 abnormal signal, high signal on anti-fat T2WI. MRI of osteosarcoma showed inhomogeneous low signal on T1WI and inhomogeneous high signal on T2WI and enhanced scan showed obvious enhancement. MRI of neurogenic tumors showed equal signal on T1WI, slightly higher signal on T2WI, obvious shift of spinal for compression and clear boundaries. MRI of malignant small round cell tumor showed high signal on T1WI, equal spinal cord signal on T2WI, follicular T1 and T2 signal in lesions and enhanced scan showed obvious homogeneous enhancement.Conclusion MRI signal, changes of peripheral soft tissue and enhancement degree of enhanced scan can be used as an important reference for the diagnosis of extramedullary epidural tumors.