椎管内少见肿瘤及肿瘤样病变MRI诊断与鉴别  

MRI diagnosis and differential diagnosis of rare tumors and tumor-like lesions in the spinal canal

作　　者：唐文英 曾珍 宋赣军 李文富 张体江 TANG Wenying;ZENG Zhen;SONG Ganjun;LI Wenfu;ZHANG Tijiang(Department of Imaging,the Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou Province 5Q300S,China)

机构地区：[1]遵义医科大学附属医院影像科,贵州遵义563003

出　　处：《实用放射学杂志》2021年第8期1238-1241,共4页Journal of Practical Radiology

摘　　要：目的探讨椎管内少见肿瘤及肿瘤样病变的MRI表现,提高对该类疾病的认识。方法回顾性分析18例经手术及病理征实的椎管内少见肿瘤及肿瘤样病变的MRI影像学资料。结果18例中,胚胎性肿瘤3例,1例包绕脊髓生长,1例横断位呈“夹心样”生长,另外1例位于腰骶段椎管内,肿瘤充满整个椎管;副神经节瘤1例,内可见迂曲状血管流空信号;血管瘤5例(毛细血管瘤2例、海绵状血管瘤3例);神经节细胞胶质瘤2例,均可见脊髓表面强化;孤立性纤维瘤(SFT)/血管外皮细胞瘤(HPC)4例,其中1例T_(2)WI可见低信号区,增强扫描低信号区明显强化;血管脂肪瘤3例,其中1例病变两端尖细呈“钢笔尖样”改变。结论部分椎管内少见肿瘤及肿瘤样病变MRI表现具有一定特征(脊髓表面强化和斑片样强化对神经节细胞胶质瘤的诊断具有提示意义,SFT/HPC多为膨胀性生长的孤立肿物,T_(2)WI低信号区增强明显强化具有一定特征性),MRI可了解椎管内肿瘤的发生部位和成分,显示病变与周围组织的关系,有助于椎管内肿瘤的诊断及鉴别诊断。Objective To explore MRI findings of rare tumors and tumor-like lesions in the spinal canal and to improve the recognition of these tumors.Methods The MRI image data of 18 patients diagnosed as rare tumors and tumor-like lesions in the spinal canal confirmed by-surgery and/or pathology examination were analyzed retrospectivly.Results In 18 cases,there were 3 cases diagnosed as embryonal tumor,in which one case grew around the spinal cord,one grew like a"sandwich11 on the axial images,and the last one was located in the lumbosacral spinal canal and entirely filled within the canal.There were 1 case diagnosed as paraganglioma with circuitous blood vessel flow voids,5 cases diagnosed as hemangioma(capillary hemangioma in 2 and cavernous hemangioma in 3),2 cases diagnosed as ganglioglioma with surface enhancement of spinal cord,4 solitary fibrous tumor(SFT)or hemangiopericytoma(HPC),in which the one was seen low signal area on T_(2)WI and obviously enhanced,and other 3 cases diagnosed as angiolipoma,in which one case presented a"pen tip"change.Conclusion The MRI findings of some rare tumors and tumor-like lesions in the spinal canal have certain characteristics.Surface and patchy enhancement of spinal cord are of significance in the diagnosis of ganglioglioma.SFT/HPC mostly present expansive solitary masses with the obvious enhancement of the low signal region on the T_(2)WI.Thus,MRI may show the location and components of the lesion,and the relationship between lesions and surrounding tissues,helping us for the diagnosis and differential diagnosis of intraspinal tumors.

关 键 词：椎管内肿瘤 肿瘤样病变 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]