椎管内硬膜外血管脂肪瘤CT、MRI表现与病理对照  

Comparison of CT and MRI Features and Histologic Appearances in Spinal Epidural Angiolipomas

作　　者：汪贯习[1] 叶葆青 杨志涛[3] 郭健[3] 高传平[3] WANG Guanxi;YE Baoqing;YANG Zhitao(Department of Radiology, Songshan Hospital, Qingdao Medical College University, Qingdao, Shandong Province 266021, P. R. China)

机构地区：[1]青岛大学医学院松山医院放射科,266021 [2]广州市红十字会医院骨科 [3]青岛大学附属医院放射科

出　　处：《临床放射学杂志》2018年第4期670-673,共4页Journal of Clinical Radiology

摘　　要：目的探讨椎管内硬膜外血管脂肪瘤的CT、MRI特点,并观察其与病理特点的对应关系。方法回顾性分析经手术病理证实的9例椎管内硬膜外血管脂肪瘤的形态特点及CT、MRI表现,并与病理特点相对照。结果9例椎管内硬膜外血管脂肪瘤,其中颈胸交界1例,胸段7例,腰段1例。9例肿块均位于椎管内背侧。肿块呈梭形,长轴与脊柱纵轴平行。肿瘤由脂肪和血管两部分构成,脂肪成分CT呈低密度,MR呈短T1、长T2信号,T2WI脂肪抑制序列呈低信号;血管成分CT呈等密度,MR T1WI呈等信号,T2WI呈高信号,增强扫描明显强化。镜下示病变主要由纤细的血管和其间成熟脂肪细胞组成。结论椎管内硬膜外血管脂肪瘤CT和MRI有相对特征性表现,但最终诊断需病理确诊。瘤体内血管和脂肪的不同比例在CT和MRI图像和镜下所见基本对应。Objective To investigate the CT and MRI features of spinal epidural angiolipomas and to compare these findings with their histologic appearances. Methods CT and MRI findings of 9 patients with surgically proved spinal epidural angiolipomas were analyzed retrospectively,and then compared with the histologic findings. Results Nine tumors located in the cervicothoracic junction（ n = 1）,thoracic vertebrae（ n = 7）,or lumbar vertebra（ n = 1） epidural space. All the lesions located in posterior of spinal canal. The mass is spindle-shaped and has a longitudinal axis parallel to that of the spine. The lesions contained fat and vascular element. The fat content was low density in CT images and was hyperintense in T1-and T2 WI images,it was hypointense on T2WI fat saturation sequences. The vascular content was isodense on CT images,it was hypointense on T1 WI and hyperintense on T2WI. The vascular component showed marked enhancement on postcontrast T1-weighted imaging. Histological examination showed that the tumor contained a mixture of mature adipocytes and cavernous vascular channels. Conclusion There are relatively typical presentations of spinal epidural angiolipomas on CT and MRI images. The pathological confirmation is the final diagnosis. The ratio of vascular and fatty component of the lesions on CT and MRI images are correlated with microscopy.

关 键 词：硬膜外肿瘤 血管脂肪瘤 体层摄影术 X线计算机 磁共振成像 病理学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R739.42[医药卫生—临床医学]