脊髓结核瘤的MR I表现分析并文献复习  

MRI findings of spinal intramedullary tuberculoma and literature review

作　　者：刘静[1] 余晖[1] 沈桂权[1] 李小宝[1] 廖欣[1] 冯辉[1] 王学建 

机构地区：[1]贵州医科大学附属医院影像科,贵州贵阳550004 [2]贵航集团贵阳医院影像科

出　　处：《实用放射学杂志》2016年第12期1831-1833,共3页Journal of Practical Radiology

基　　金：贵州医科大学附属医院临床基金（I-2012-1）.

摘　　要：目的：分析脊髓结核瘤的 MRI表现并文献复习。方法回顾性分析5例经临床和影像证实的脊髓结核瘤患者 MRI表现，所有患者MRI检查包括T1 WI、T2 WI平扫和T1 WI增强扫描，观察病变的部位、信号特点、强化方式和形态。结果1例病变位于颈段脊髓，为稍长T1、短T2信号，呈结节样强化；3例病变位于下胸段脊髓，横断位T2 WI表现为典型的“靶征”，增强后呈环状强化，矢状位其长轴与脊髓长轴一致，其中1例增强后发现合并1个平扫不能显示的粟粒强化结节；1例病变位于脊髓圆锥，为长 T1、短T2信号，增强后呈环状强化。结论脊髓结核瘤 MRI表现具有多样性，其特征性表现包括 T2 WI 低信号或“靶征”、环状强化、病变长轴与脊髓长轴一致。Objective To analyze the MRI findings of spinal intramedullary tuberculomas and the related literature was reviewed. Methods A retrospective study of 5 patients with intramedullary tuberculoma proved by clinical and radiological evidences was undertaken.Both T1-and T2-weighted images were obtained along with the postcontrast T1 WI.The locations,signal intensities,patterns of enhancement and morphology of the tuberculomas were observed.Results A tuberculoma in one patient was found in cervical spinal cord with slight hypointensity and nodular enhancement on T1 WI and hypointensity on T2 WI.Those in three patients were found in inferior thoracic spinal cord with typical “target sign”on T2 WI and rim-enhancement on postcontrast T1 WI,and the tuberculomas were ovoid along the long axis of spinal cord on sagittal images.A miliary tuberculoma in thoracic spinal cord in one of these three patients was found which could not be showed on plain MRI.The tuberculomas in last patient was located in conus terminalis with hypointensity and rim enhancement on T1 WI and hypointensity on T2 WI.Conclusion The MRI findings of spinal intramedullary tuberculoma are variable,and their characteristic manifestations include hypointensity or “target sign”on T2 WI,rim enhancement on postcontrast T1 WI along the long axis of spinal cord.

关 键 词：结核瘤 脊髓 磁共振成像 

分 类 号：R529.3[医药卫生—内科学] R445.2[医药卫生—临床医学]