放射性脊髓病MRI表现  

MRI manifestations of radiation myelopathy

作　　者：陈慧莹 孙兴文 韩嵩博[1] 袁慧书[1] 张立华[1] CHEN Huiying;SUN Xingwen;HAN Songbo;YUAN Huishu;ZHANG Lihua(Department of Radiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院放射科,北京100191

出　　处：《中国医学影像技术》2024年第12期1900-1903,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察放射性脊髓病(RM)MRI表现。方法回顾性纳入9例于手术切除肿瘤后接受放射治疗(放疗)而发生RM患者,分析其临床及影像学资料。结果平扫MRI中,9例RM均表现为脊髓肿胀、增粗,C1~T5水平均可受累,呈T1WI低信号、T2WI高信号;脊髓水肿长度30~178 mm,中位数90 mm;病变累及脊髓侧索8例、灰质9例、后索7例。4例接受增强扫描,RM病变均呈结节样或条片样中等程度强化,长度19~53 mm,其分布与手术区域相符。4例接受MRI随访,期间脊髓水肿范围逐渐缩小,或先扩大后缩小。结论RM主要MRI表现包括脊髓增粗、水肿,呈T1WI低信号、T2WI高信号;增强后部分呈结节样或条片样中等程度强化,强化部位与手术区域一致。Objective To observe MRI manifestations of radiation myelopathy(RM).Methods Nine patients who developed RM due to radiotherapy after tumor resections were retrospectively enrolled,and clinical and imaging data were analyzed.Results Non-contrast enhanced MRI showed spinal cord swelling and thickening in all 9 cases,which could involve C1—T5 level,presented as low signals on T1WI and high signals on T2WI.The length of spinal cord edema was 30—178 mm,with a median of 90 mm.Lateral spinal cord involvements were detected in 8 cases,gray matter involvements were found in 9 cases,while posterior spinal cord involvements were noticed in 7 cases.Enhanced scanning was performed in 4 cases,and RM lesions presented as moderate"nodule"or"strip"like enhancements with length of 19—53 mm,and their distribution consistent with tumor resection areas.Four patients underwent MRI follow-up,the ranges of spinal cord edema gradually decreased or expanded at first and then decreased.Conclusion RM mainly presented as spinal cord thickening and edema on MRI,with low signals on T1WI and high signals on T2WI.Moderately"nodule"or"strip"like enhancements could occur in some lesions,with distribution consistent with surgical resection areas.

关 键 词：脊髓炎 放射治疗 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]