Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess th...Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.展开更多
Introduction: Spinal schwannomas also known as neurinomas are often benign slow growing lesion that may develop from Schwann cells of the spinal roots, it is a nerve sheath tumor. The authors reported a case of a pati...Introduction: Spinal schwannomas also known as neurinomas are often benign slow growing lesion that may develop from Schwann cells of the spinal roots, it is a nerve sheath tumor. The authors reported a case of a patient presenting a hyperalgesic lumbosciatica symptomatic of a spinal schwannoma. Observation: A 36-year-old female patient, with a history of asthma under treatment was admitted to our department because of one year lasting of an intermittent fashion bilateral L5 hyperalgesic lumbosciatica. The initial examination has shown back muscles contractures and a segmental deficit of the right lower limb in L5 and S1, but no genital or sphincter disorders were noted. The lumbosacral CT scan was without particularity but the magnetic resonance imaging (MRI) revealed an intradural, extra medullary lesion at the level of L1-L2. A monobloc resection of the lesion was done. The follow-up is good. Pathology concluded in schwannoma WHO grade I classification. Conclusion: Lumbar neurinoma that grows slowly is most often manifested by a radiculalgia often hyperalgesic and disabling. MRI is the examination of choice to make the diagnosis and complete removal is possible.展开更多
基金funded by the National Natural Science Foundation of China (No. 81460259)
文摘Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.
文摘Introduction: Spinal schwannomas also known as neurinomas are often benign slow growing lesion that may develop from Schwann cells of the spinal roots, it is a nerve sheath tumor. The authors reported a case of a patient presenting a hyperalgesic lumbosciatica symptomatic of a spinal schwannoma. Observation: A 36-year-old female patient, with a history of asthma under treatment was admitted to our department because of one year lasting of an intermittent fashion bilateral L5 hyperalgesic lumbosciatica. The initial examination has shown back muscles contractures and a segmental deficit of the right lower limb in L5 and S1, but no genital or sphincter disorders were noted. The lumbosacral CT scan was without particularity but the magnetic resonance imaging (MRI) revealed an intradural, extra medullary lesion at the level of L1-L2. A monobloc resection of the lesion was done. The follow-up is good. Pathology concluded in schwannoma WHO grade I classification. Conclusion: Lumbar neurinoma that grows slowly is most often manifested by a radiculalgia often hyperalgesic and disabling. MRI is the examination of choice to make the diagnosis and complete removal is possible.
