椎管内色素性神经鞘瘤的MRI影像学特点分析  

MRI features of melanotic schwannoma in spinal canal

作　　者：杨欢[1] 高剑波[1] 梁盼[1] Yang Huan;Gao Jianbo;Liang Pan(Department of Radiology, the First Afiliated 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,450052

出　　处：《中国实用医刊》2019年第12期30-32,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨椎管内色素性神经鞘瘤的MRI表现,提高对本病的影像学认识和诊断水平。方法收集郑州大学第一附属医院2008年7月至2018年8月术后病理学检查证实为椎管内色素性神经鞘瘤患者5例,5例患者均行MRI平扫、增强检查,回顾性分析其临床特征及MRI表现。结果5例患者中,病变发生在颈段2例,胸段2例,腰骶段1例;发生在髓内1例,单纯硬膜下2例,硬膜外2例;3例病变单发,2例病变多发;边界光整4例,模糊1例;椎间孔扩大2例,椎体及椎间孔骨质受累1例。MRI显示肿瘤在T1WI呈高信号3例,等、稍高混杂信号1例,等信号1例;T2WI信号不均匀3例,其内均可见极低信号;增强后不均匀强化者3例,均匀强化者2例,1例邻近脊膜强化。结论椎管内色素性神经鞘瘤表现为急性病程,肿瘤多位于髓外硬膜下,可单发,并有多发倾向,T1WI呈高信号,T2WI内出现极低信号,增强后中度强化,不均匀强化区与神经鞘瘤相似。MRI对本病有助于诊断,并确定侵犯范围。Objective To investigate the magnetic resonance imaging (MRI) findings of spinal canal melanotic schwannoma and to improve the imaging knowledge and diagnosis ability of the disease. Methods Five patients with intraspinal pigmented schwannoma confirmed by pathological examination from July 2008 to August 2018 in the First Affiliated Hospital of Zhengzhou University were collected. Five patients underwent plain and enhanced MRI examinations. The clinical features and MRI findings were retrospectively analyzed. Results Two cases of 5 patients were at the cervical level;2 cases, the thoracic level;1 case, at the lumbar level. One case occurred in the intramedulla;2 cases, in the subdural;2 cases, in the epidural. Three cases had single lesions and 2 cases were multiple. Four cases were boundary smoothing and 1 case was ambiguity. Two cases were intervertebral foramen enlargement, and 1 case was with vertebral body and intervertebral foramen infringed. On MRI, 3 cases showed hyperintensity on T1WI, 1 case of equal signal and 1 case of mixed mild hyperintensity;3 cases were uneven on T2WI, and all of 5 cases had extremely hyprointensity;there were 3 cases of uneven enhancement, 2 cases of even enhancement, and 1 case of adjacent meningeal enhancement. Conclusions Pigmented neurilemmoma in spinal canal manifests as an acute course. Most of the tumors are located under the extramedullary dura. They are solitary and tended to be multiple. T1WI shows high signal intensity, and very low signal intensity appeared in T2WI. After enhancement, they show moderate enhancement. The uneven enhancement area is similar to that of neurilemmoma. MRI is helpful in diagnosing this disease and determining the extent of invasion.

关 键 词：椎管 色素性神经鞘瘤 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]