脊髓血管母细胞瘤的MRI诊断

MRI diagnosis of spinal hemangioblastoma

目的分析探讨脊髓血管母细胞瘤的MRI表现,提高该病的影像诊断水平。方法回顾分析经临床、手术病理证实的15例脊髓血管母细胞瘤的临床特征及MRI表现。全部患者均行MRI平扫及增强扫描,分析其MRI影像学特征(主要包括部位、形态、大小、信号特点、有无流空血管、瘤周水肿以及脊髓空洞等)。结果大囊小结节型3例(20%),实性结节型12例(80%);颈段9例(60%),胸段2例(13%),腰骶段4例(27%);单发13例(87%),多发2例(13%),其中1例合并VHL综合征(VHL)。6例(40%)肿瘤的最大径≥3 cm,其余肿瘤最大径均<3 cm;10例(67%)肿瘤内部及周围见增粗、迂曲流空血管影,4例(27%)肿瘤继发脊髓空洞,6例(40%)肿瘤周围广泛脊髓水肿,5例(33%)肿瘤未见脊髓空洞及周围水肿改变,其中1例脊髓空洞合并脊髓水肿。结论脊髓血管母细胞瘤的MRI表现具有一定的特征性,肿瘤内部及周围多见流空血管、增强以后显著强化,常伴发瘤周水肿或脊髓空洞。MRI对脊髓血管母细胞瘤的鉴别诊断和术前评估具有重要价值。

Objective Analyze the MRI manifestations of spinal hemangioblastoma to improve the imaging diagnosis of the disease.Methods The clinical features and MRI manifestations of 15 patients with spinal hemangioblastoma confirmed by clinical and surgical pathology were retrospectively analyzed.All patients underwent plain MRI scans and enhanced scans,and analyzed their MRI imaging features(mainly including location,shape,size,signal characteristics,presence of empty blood vessels,peritumoral edema,and spinal cavity).Results Large cyst with mural nodule was showed in 3 cases(20%),and solid nodule was found in 12 cases(80%);Nine lesions at the cervical spinal cord(60%),two lesions(13%)at the thoracic spinal cord and four lesions(27%)at the Lumbosacral spinal cord.The hemangioblastomas showed single lesion in thirteen patients(87%)and showed multiple lesions in two cases(13%)by MRI,one of the cases was associated with VHL syndrome(Von Hippel-Lindau disease,VHL).The maximum diameter of the tumors was more than 3cm in 6 cases(40%),and less than 3 cm in 9 cases.10 cases(67%)showed vascular flow voids in and around the tumor,4 cases(27%)were accompanied syringes,6 cases(40%)were accompanied by peritumoral edema,and 5 cases(33%)there were no changes in syringes and peritumoral edema in the tumor,including 1 case of syringes with peritumoral edema.Conclusion Spinal cord hemangioblastoma have certain characteristic MRI findings,the tumors invariably had vascular flow voids or around the tumor,significantly enhanced after enhancement and tumors were often mixed with peritumoral edema and syringes.MRI plays an important role in differential diagnosis and preoperative evaluation of spinal cord hemangioblastoma.