椎管内硬膜外血管脂肪瘤的MRI表现及鉴别诊断  

MRI features and differential diagnosis of spinal epidural angiolipomas

作　　者：周欢[1,2] 许宏伟[3] 袁慧书[1] 

机构地区：[1]北京大学第三医院放射科,北京100191 [2]河北大学附属医院CT/MRI室,河北保定071000 [3]承德市中心医院放射科,河北承德067000

出　　处：《中国医学影像技术》2017年第8期1252-1255,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨椎管内硬膜外血管脂肪瘤的MRI表现。方法回顾性分析经病理确诊的18例椎管内硬膜外血管脂肪瘤患者的临床和影像资料,分析其病变部位、肿块大小、形态、信号、骨质破坏情况、增强特点及分型。结果 18例肿瘤位于颈椎1例、胸椎15例、腰椎2例。10例肿瘤经椎间孔或破坏相邻骨质达椎管外形成椎旁肿块。MRI显示T1WI呈等信号11例、混杂信号5例、稍高信号2例;T2WI呈高信号13例、混杂信号5例。5例肿瘤内部可见点片状脂肪信号,T1WI、T2WI呈高信号。增强扫描18例均明显强化。Ⅰ型(病变局限于椎管内)8例(8/18,44.44%),Ⅱ型(病变呈哑铃状突至椎管外)10例(10/18,55.56%)。结论椎管内硬膜外血管脂肪瘤发病部位及MRI表现具有一定的特征,对术前正确诊断有重要提示意义。Objective To investigate the MRI features of spinal epidural angiolipomas.Methods Clinical and MRI data of 18 patients with spinal epidural angiolipomas confirmed pathologically were retrospective analyzed.The MRI features of lesion site,size,shape,signal,bone destruction,enhancement and typing were observed and analyzed.Results One case of 18 cases were located in cervical vertebra,15 cases were thoracic vertebra,and 2 cases were lumbar vertebra.Ten cases formed paravertebral lump through foramen intervertebrale and damaged adjacent bones.MRI showed that T1W1 signal intensity was either isointense（n=11）,mixed intense（n=5）or hyperintense（n=2）.T2WI showed signal intensity was hyperintense（n=13）or mixed intense（n=5）.The fat signal was seen in 5 cases,both T1W1 and T2W1 showed hyperintense.All the 18 cases showed remarkable enhancement.Ⅰtype（lesions confined to the spinal canal）was 8 cases（8/18,44.44%）,Ⅱ type（lesions were dumbbell-shaped to the spinal canal）was 10 cases（10/18,55.56%）.Conclusion The location of occurrence and the manifestations of MRI in spinal epidural angiolipomas have certain characteristics,which provides important clues to the preoperative diagnosis.

关 键 词：脊柱肿瘤 血管脂肪瘤 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]