椎管内硬膜外血管脂肪瘤的MRI表现  

Spinal epidural angiolipomas: MRI features

作　　者：胡春洪[1] 丁乙[1] 王雪元[1] 傅引弟[1] 郭亮[1] 沈海林[1] 陈剑华[1] 

机构地区：[1]苏州大学附属第一医院影像中心,215006

出　　处：《中华放射学杂志》2004年第11期1176-1179,共4页Chinese Journal of Radiology

摘　　要：目的　探讨MRI对椎管内硬膜外血管脂肪瘤的诊断价值。方法　回顾性分析经手术病理证实的 7例椎管内硬膜外血管脂肪瘤的MRI表现 ,并进行MR分型。结果　 7例均位于胸段椎管 ,其中上胸段 2例 ,中胸段 2例 ,下胸段 3例。肿块位于硬膜外 ,呈梭形 ,长轴与脊柱纵轴平行 ,肿瘤的MR信号由脂肪和血管 2部分构成 ,血管成分在T1WI呈低信号 ,T2 WI为高信号 ,可明显强化 ,未见血管流空影。全部病例依MRI表现分 3型 :Ⅰ型 2例 ,特点是血管成分稀少 ,呈细条状、斑点状夹杂于脂肪组织间 ;Ⅱ型 3例 ,特点是血管成分呈团块状 ,占据瘤体的中央 ;Ⅲ型 2例 ,肿瘤沿一侧或双侧椎间孔向椎管外生长 ,形成哑铃状外观。结论　MRI是诊断此病的最佳方法 ,并具有相对特征性表现。Objective To evaluate the diagnostic value of MRI in spinal epidural angiolipomas.Methods Seven surgically proved cases of spinal epidural angiolipomas were retrospectively reported, and the lesion was classified according to the MR findings.Results Seven tumors were located in the superior (n=2), middle (n=2), or inferior (n=3) thoracic level. The mass, with the shuttle shape, was located in the epidural space and extended parallel to the long axis of spine. All lesions contained fat and vascular element. The vascular content, correlating with the presence of hypointense regions on T 1WI and hyperintense signals on T 2WI, had marked enhancement. But there was no flow void signs on MR images. All tumors were divided into three types based on the MR features. In type one (n=2), the mass was predominantly composed of lipomatous tissue and contained only few small angiomatous regions, which had a trabeculated or mottled appearance. In type two (n=3), the mass, however, was composed predominantly of vascular components, which showed large foci in the center of the mass. In type three (n=2), the lesions grew through one or both side of intervertebral foramina, and produced a dumbbell appearance.Conclusion With the relative typical presentation, MRI is considered the modality of choice for the diagnosis of spinal epidural angiolipomas. The classification based on MR features is helpful for the diagnosis and differential diagnosis of the disease.

关 键 词：硬膜外 血管脂肪瘤 胸段 椎管内 MRI表现 肿瘤 分型 信号 斑点 长轴 

分 类 号：R738[医药卫生—肿瘤]