椎旁型脊柱血管瘤与神经鞘瘤的MRI鉴别诊断  

Differential diagnosis between paravertebral spinal hemangioma and neurilemmoma using MRI

作　　者：杨欢[1] 高剑波[1] 梁盼[1] YANG Huan;GAO Jianbo;LIANG Pan(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院放射科,河南郑州450052

出　　处：《实用放射学杂志》2019年第6期865-868,共4页Journal of Practical Radiology

摘　　要：目的分析椎旁型脊柱血管瘤和神经鞘瘤的MRI表现及鉴别诊断特征.方法回顾性分析经手术及病理证实为椎旁型脊柱血管瘤11例和椎旁型神经鞘瘤患者17例的MRI和临床资料.结果椎旁型脊柱血管瘤位于胸段硬膜外,T2WI呈高信号,似脑脊液,增强后明显均匀强化,伴同层椎体破坏和椎体血管瘤.椎旁型神经鞘瘤位于中上颈段和胸段硬膜内外,T2WI信号不均匀,实性区域呈稍高信号,其内不规则片状更高信号,不均匀明显强化,囊变区不强化.对比2组病例,在病灶发生位置、伴发椎体血管瘤、病变同层椎体受累、病变与脊髓关系、T2WI信号、强化方式差异有统计学意义(P<0.05).在年龄、性别、临床表现,形态、体积、附件受累、T1WI信号差异无统计学意义(P>0.05)。结论椎旁型脊柱血管瘤与神经鞘瘤的MRI表现在位置、伴发椎体血管瘤、病变同层椎体受累、病变与脊髓关系、T2WI信号、强化方式方面存在差异,充分认识MRI表现有助于诊断。Objective To diagnose correctly for paravertebral spinal hemangioma and neurilemmoma through retrospective analysis of characteristics of MRI.Methods Paravertebral spinal hemangiomas (n=11)and neurilemmomas (n=17)confirmed by surgery and pathology were analyzed retrospectively.Results Paravertebral spinal hemangiomas occurred in the thoracic epidural,hyperintense singal on T2 WI,obvious homogeneous enhancement,associated with vertebral body destruction and vertebral hemangioma.Paravertebral neurilemmomas were located in the middle and upper cervical segments and the thoracic epidural space.The solid area showed mild hyperintense singal on T2 WI,irregularly higher hyperintense signal inside,and obvious heterogeneous enhancement,without the cystic area being enhanced.The differences between the two tumors were significant in location,vertebral hemangioma,lesions of the same layer of bone destruction,relationship with the spinal cord,T2 WI signal,and enhanced performance (P<0.05 ).There were no significant differences in age,sex,clinical manifestation,shape,volume,affected attachment,and T1 WI signal (P>0.05 ).Conclusion The MRI findings of paravertebral spinal hemangioma and neurilemmoma are significantly different in the location,vertebral hemangioma,bone destruction,relationship with the spinal cord,T2 WI signal and enhanced performance.

关 键 词：脊柱 血管瘤 神经鞘瘤 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤] R730.264[医药卫生—临床医学]