白血病浸润硬脊膜并形成硬膜外肿块的MRI表现(2例报告并文献复习)  

MRI Appearances of Leukemic Dural Infiltration Complicated by the Formation of Epidural Mass: Report of 2 Cases with Literature Review

作　　者：李丹[1] 赵天平[1] 程敬亮[2] 张勇[2] 

机构地区：[1]河南省焦作市人民医院磁共振室,454150 [2]郑州大学第一附属医院磁共振室,450052

出　　处：《临床放射学杂志》2015年第2期308-310,共3页Journal of Clinical Radiology

摘　　要：目的探讨白血病硬脊膜浸润并形成硬膜外肿块的MRI表现及其诊断和鉴别诊断。方法回顾性分析经病理证实的2例白血病硬脊膜浸润并形成硬膜外肿块的影像学和临床资料。2例均行确诊前及治疗后MRI平扫及增强扫描。结果 2例均表现为胸段长范围硬脊膜增厚并形成局限性硬膜外软组织块,压迫并半包绕脊髓;呈等或略长T1、稍长T2信号,增强扫描硬脊膜增厚,硬膜外肿块均匀中度或明显强化。2例均伴有胸椎椎体的异常浸润。经抗白血病治疗后复查MRI显示硬膜外肿块减小几近消失。结论椎管硬膜外腔有软组织块占位,MRI与脊髓相比呈等或稍长T1、略长T2信号,增强扫描均匀中度或明显强化时,应考虑白血病浸润的可能。Objective To investigate the MRI appearances of leukemic dural infiltration associated with the formation of epidural mass, and to discuss its diagnosis and differential diagnosis. Methods The imaging materials and the clinical data of two patients with pathologically-proved leukemic dural infiltration associated with the formation of epidural mass were retrospectively analyzed. Both preoperative and postoperative plain as well as contrast-enhanced MRI scans were performed in the two patients. Results In both cases the lesions were characterized by long thickening of thoracic dura with the for- mation of localized epidural soft tissue mass, and the spinal cord was oppressed and semi-wrapped ; the lesion presented as iso-T1 or slightly long-T1 and slightly long-T2 signal on MRI; on contrast-enhanced MRI scan the thickening of dura was ob- served, and the epidural mass displayed homogeneous moderate-to-significant enhancement. Abnormal infiltration of thorac- ic vertebrae was detected in both cases. After anti-leukemia treatment, MRI reexamination showed that the epidural mass shrank, or almost disappeared. Conclusion A space-occupying soft tissue mass in epidural cavity, which presents as iso-T1 or slightly long-T1 and slightly long-T2 signal on MPd with homogeneous moderate-to-significant enhancement, is highly suggestive of leukemic dural infiltration.

关 键 词：白血病 硬脊膜浸润 硬膜外肿块 磁共振成像 

分 类 号：R733.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]