脊髓转移瘤MRI诊断  

MR imaging diagnosis of intramedullary spinal cord metastasis

作　　者：陆璐[1] 叶彩林 马冰雪[1] 刘文慧[1] 余永强[1] 钱银锋[1] 

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022

出　　处：《实用放射学杂志》2015年第12期1950-1952,1955,共4页Journal of Practical Radiology

摘　　要：目的 探讨脊髓转移瘤（ISCM）MRI表现，提高对该病的认识。方法 回顾性分析14例经临床证实的ISCM患者，均行MRI平扫，10例行增强扫描，总结其MRI表现特征。结果 14例ISCM患者平均病程1.5个月。仅1例多发，位于胸髓；13例单发，其中颈髓4例，胸髓7例，圆锥2例。9例患者同时出现脑转移，8例骨转移，4例肺转移，肝脏和肾上腺转移各2例。病灶在T1WI上低信号6例，等信号6例，等低混杂信号2例；T2WI上高信号2例，稍高信号7例，等信号3例，混杂信号2例。增强后3例均匀性强化，5例不均匀性强化，2例环形强化；其中4例边缘呈毛刺或火焰样。病灶长度平均为1.2个椎体高度，瘤周水肿平均为6.7个椎体高度，1例伴有脊髓中央管扩张。 结论 ISCM的MRI表现有一定的特征，结合临床表现有助于提高对本病的认识及诊断。Objective To improve the recognition to intramedullary spinal cord metastasis （ISCM） by discussing the MRI features of the disease. Methods 14 patients clinically diagnosed with ISCM were retrospectively analyzed. All of the patients underwent conventional MR imaging, and 10 cases underwent MR contrast enhancement imaging. Then the MRI appearances of ISCM were summarized. Results The mean course of ISCM was 1.5 months. Only one case had multiple lesions located in thoracic cord,13 cases had solitary lesion,among which 4 lesions were in cervical cord,7 in thoracic cord and 2 in conus. 9 patients had brain metastases, 8 patients had bone metastases,4 patients had lung metastases, 2 patients had adrenal metastases and 2 patients had hepatic metastases. T1 WI showed hypointensity in 6 cases,isointensity in 6 cases and heterogeneity intensity in 2 cases. T2 WI showed hyperintensity in 2 cases, slightly hyperintensity in 7 cases,isointensity in 3 cases and heterogeneity intensity in 2 cases. After contrast administration,3 cases presented homogeneous enhancement, 5 cases heterogeneous enhancement and 2 cases rim enhancement. Of all the cases, 4 showed spicular or flame margin. The average length of ISCMs and peritumor cord edema was 1.2 and 6.7 vertebral segments,one case of patient had syringomyelus, respectively. Conclusion The MRI manifestation of ISCM has certain characteristics. Combined with clinical manifestations, MRI is significantly helpful to improve the cognition and diagnosis of ISCM.

关 键 词：脊髓内肿瘤 转移 磁共振成像 

分 类 号：R739.42[医药卫生—肿瘤] R445.2[医药卫生—临床医学]