脊柱转移瘤MRI诊断(附45例报告)  

MRI Diagnosis of Spinal Metastasis (A Report of 45 Cases )

作　　者：邱乾德[1] 陈祈平[1] 许家俊[1] 叶大春[1] 白静深[1] 何晓华[1] 虞栋[2] 

机构地区：[1]浙江省温州市第三人民医院影像科,浙江温州325000 [2]浙江医科大学临床医学影像专业大4班

出　　处：《实用放射学杂志》2004年第5期438-441,共4页Journal of Practical Radiology

摘　　要：目的　探讨MRI对脊柱转移瘤的敏感性 ,以提高脊柱转移瘤MRI表现的认识。方法　回顾性分析 45例脊柱转移瘤的MRI表现 ,结合文献进行讨论。结果　 45例中共累及 14 9节椎体 ,累及椎弓根 19例 3 2根 ,棘突及横突 7例 11处。椎体压缩呈盘状 8例 2 1节 ,呈楔状 7例 11节 ,病椎轻度膨胀 4例 ,有软组织肿块 18例 ,硬膜囊、脊髓受压 15例 ,脊髓受侵 2例。病椎信号均匀 2 8例 ,不均匀 17例。T1WI为明显低信号 15例 ,略低信号 2 7例 ,等信号 3例。T2 WI为明显高信号 17例 ,略高信号 2 5例 ,等信号 3例。增强 18例 ,病灶明显强化 11例 ,轻度强化 6例 ,不强化 1例。软组织肿块边缘水肿、受压和受侵脊髓在MRI上均显示阳性。结论　MRI检查脊柱转移瘤的敏感性明显优于CT和X线平片 ,尤其肿瘤浸润椎骨尚属水肿、出血、坏死阶段时。Objective To investigate the MRI features and to improve the knowledge of the spinal metastasis.Methods The MRI findings of the spinal metastasis were analysed in 45 cases with the review of literature.Results There were 45 cases in 149 vertebral body with metastasis in this paper.32 radix arcus vertebrae in 19 cases,11 processus spinosus and processus transversus in 7 cases were involved.The vertebral bodies involved appeared as dicoid in 21 (8 cases)and cuneiforme in 11 (7 cases),expansion in 4.There were soft-tissue masses in 18 cases.The dura sac and spinal cord were pressured in 15 cases,spinal cords were involved in 2 cases.The signal intensity on MRI was homogeneous in 28 and inhomogeneous in 17,hypointense in 15,slight hypointense in 27 and isointense in 3 on T 1WI,hyperintense in 17,slight hyperintense in 25 and isointense in 3 on T 2WI.18 cases were examined by enhanced-contrast MRI,postcontrast scans showed enhancement strongly in 11 cases,slight enhanced in 6 cases and but one.Conclusion MRI is sensitivity in detecting the spinal metastasis,especially during the period of edema,bleeding and necrosis of lesions.

关 键 词：脊柱转移瘤 MRI 诊断 磁共振成像 鉴别诊断 

分 类 号：R738.1[医药卫生—肿瘤] R730.4[医药卫生—临床医学]