椎管内棘球蚴病的磁共振成像及临床表现  

Magnetic resonance imaging and clinical manifestations of intraspinal echinococcosis

作　　者：常玉山 何雄 帕哈提·吐逊江 刘文亚 郭辉[1] Chang Yushan;He Xiong;Pahati·Tuxunjiang;Liu Wenya;Guo Hui(Department of Radiology,the Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Radiology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第四附属医院影像中心,乌鲁木齐830000 [2]新疆医科大学第一附属医院影像中心,乌鲁木齐830054

出　　处：《中华地方病学杂志》2024年第5期411-415,共5页Chinese Journal of Endemiology

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2021-22)

摘　　要：目的探讨椎管内棘球蚴病的磁共振成像(MRI)及临床表现。方法回顾性分析新疆医科大学第一附属医院2011年9月至2023年5月经病理确诊的23例椎管内棘球蚴病患者的一般情况、MRI及临床表现。结果23例椎管内棘球蚴病患者,男10例、女13例;年龄为(44.1±13.9)岁,年龄中位数为41岁,范围为25~72岁。11例(47.8%)患者有脊柱或其他部位棘球蚴病史。23例椎管内棘球蚴病患者中,累及胸段12例(52.2%),累及腰段6例(26.1%),累及骶段1例(4.3%),同时累及胸腰段1例(4.3%),同时累及腰骶段2例(8.7%),同时累及颈腰段1例(4.3%);累及髓内2例(8.7%),累及髓外硬膜下9例(39.1%),累及髓外硬膜外12例(52.2%);同时累及邻近椎体、附件或周围软组织18例(78.3%)。髓内囊型棘球蚴病MRI表现为脊髓下端及马尾神经处多发结节,T1WI呈等或低信号,T2WI及短时反转恢复序列(STIR)呈稍高信号,伴T2WI高信号的小囊泡;髓内泡型棘球蚴病表现为结节状T1WI等信号,T2WI及STIR呈稍低信号,增强扫描呈环形强化。髓外硬膜下棘球蚴病多表现为卵圆形T1WI低信号、T2WI高信号小囊泡,葡萄串样外观,边缘见T2WI低信号的囊壁。髓外硬膜外棘球蚴病表现为T1WI稍低信号、T2WI及STIR高信号,伴单发或多发T2WI高信号的小囊泡,硬膜囊受压。临床表现为胸背部、腰骶部疼痛者21例(91.3%),双下肢功能障碍者6例(26.1%)。结论椎管内棘球蚴病相对其他部位较罕见,当MRI特征明确、具有典型临床表现或有其他部位棘球蚴病史时,要考虑椎管内棘球蚴病。Objective To study the magnetic resonance imaging(MRI)and clinical manifestations of intraspinal echinococcosis.Methods The general conditions,MRI and clinical manifestations of 23 patients with intraspinal echinococcosis diagnosed by pathology at the First Affiliated Hospital of Xinjiang Medical University from September 2011 to May 2023 were retrospectively analyzed.Results There were 10 males and 13 females of the 23 patients with intraspinal echinococcosis.The age of the patients was(44.1±13.9)years old,with a median age of 41 years old and a range of 25 to 72 years old.Eleven patients(47.8%)had a history of echinococcosis in the spine or other parts of the body.Among the 23 patients with intraspinal echinococcosis,12 cases(52.2%)involved thoracic segment,6 cases(26.1%)involved lumbar segment,1 case(4.3%)involved sacral segment,1 case(4.3%)involved thoracolumbar segment,2 cases(8.7%)involved lumbosacral segment,and 1 case(4.3%)involved cervical and lumbar segment.There were 2 cases(8.7%)involving the intramedullary,9 cases(39.1%)involving the extramedullary subdural,and 12 cases(52.2%)involving the extramedullary epidural.At the same time,18 cases(78.3%)involved adjacent vertebral bodies,accessories or surrounding soft tissues.Intramedullary cystic echinococcosis was characterized by multiple nodules at the lower end of the spinal cord and the cauda equina nerve on MRI,with equal or low signal on T1WI,slightly high signals on T2WI and short time of inversion recovery(STIR),accompanied by small vesicles with high signal on T2WI.Intramedullary alveolar echinococcosis was characterized by nodular T1WI signals,slightly lower signals on T2WI and STIR,and circular enhancement on enhanced scan.Extramedullary subdural echinococcosis was mostly manifested as oval small vesicles with low signal on T1WI and high signal on T2WI,with a grape string-like appearance,and the capsular wall with low signal on T2WI could be seen at the edge.Extramedullary epidural echinococcosis was manifested as slightly low signal on T1WI,hi

关 键 词：棘球蚴病 椎管内 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R532.32[医药卫生—诊断学]