椎管内副神经节瘤的MRI、病理分析及鉴别诊断

MRI,Pathological Analysis,and Differential Diagnosis of Intraspinal Paraganglioma

目的分析椎管内副神经节瘤的MRI表现,加强并提高对改病的认识与鉴别诊断能力。方法回顾性分析7例发生于椎管内经病理证实为副神经节瘤患者的临床、病理及MRI资料,所有患者均行MRI平扫及增强检查。结果7例均为男性,年龄22~75岁不等,平均年龄约(45.8±16.8)岁。病例均为腰段椎管内单发病灶,L2-L3节段4例(57.1%),L3-4节段2例(28.6%),L4节段1例(14.3%),所有病灶最长径均未超过2个锥体。较小病灶呈类圆形肿块,较大病灶沿椎管长轴生长。T_(1)WI呈等或稍低信号,T_(2)WI信号多不均匀,以稍高信号为主,5例增强扫描呈明显均匀强化,2例呈不均匀明显强化。4例(57.1%)瘤体上面见迂曲血管流空信号。结论椎管内副神经节瘤较为罕见,其MRI表现有一定特点,充分认识其MRI表现,有助于对该病鉴别诊断。

Objective To analyze the MRI findings of intraspinal paraganglioma in order to strengthen and improve the understanding and differential diagnosis of the disease.Methods The clinical,pathological and MRI data of 7 patients with intraspinal paraganglioma confirmed by pathology were analyzed retrospectively.All patients were examined by plain and enhanced MRI.Results All the 7 cases were male,ranging in age from 22 to 75 years old,with an average age of(45.8±16.8)years.All the cases were single lesions in the lumbar spinal canal.L2-L3 segment was found in 4 cases(57.1%),L3-L4 segment in 2 cases(28.6%),and L4 segment in 1 case(14.3%).The longest diameter of all lesions was less than 2 cones.The smaller lesions showed a quasi-round mass,and the larger lesions grew along the long axis of the spinal canal.T_(1)WI showed equal or slightly low signal intensity T_(2)WI signal intensity was mostly inhomogeneous,mainly slightly high signal intensity,5 cases showed obvious uniform enhancement,2 cases showed inhomogeneous enhancement.Tortuous vascular flow void signal was seen on the tumor in 4 cases(57.1%).Conclusion Intraspinal paraganglioma is rare and its MRI findings have certain characteristics.A full understanding of its MRI findings is helpful for differential diagnosis.