| 张静,王培军,袁小东,唐俊军,武刚,王国良.脊髓髓内转移性肿瘤的MRI诊断及鉴别诊断[J].中国医学影像技术,2007,23(6):852~854 |
| 脊髓髓内转移性肿瘤的MRI诊断及鉴别诊断 |
| MR imaging diagnosis and differential diagnosis of intramedullary spinal cord metastasis |
| 投稿时间：2006-11-24 修订日期：2007-05-12 |
| DOI： |
| 中文关键词: 脊髓肿瘤 转移 磁共振成像 鉴别诊断 |
| 英文关键词:Spinal cord neoplasms Metastasis Magnetic resonance imaging Differential diagnosis |
| 基金项目: |
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| 中文摘要: |
| 目的 分析脊髓髓内转移性肿瘤(ISCM)MRI表现及其同髓内常见肿瘤的鉴别要点,提高对脊髓内肿瘤的认识和诊断水平。方法 回顾性分析11例临床及病理证实的ISCM病例的临床与MRI资料,所有病例均行MRI平扫及增强检查。结果 4例经手术病理证实,7例经临床确诊 ,6例为多发病灶:颈、胸髓、圆锥、马尾均可多节段发生;5例为单发病灶:3例位于圆锥,1例位于颈髓,1例位于颈髓、延髓交界部。MR平扫T1WI多表现为等、低信号,T2WI多表现为不均匀高信号,增强后病灶均明显强化,可表现为斑片状、环形、斑点状及结节状强化,伴随征象包括脊髓增粗、周围水肿、脊髓空洞等。结论 MRI能较好地显示ISCM的内部结构及信号特点、明确肿瘤的范围及进展情况,有助于本病的诊断及鉴别诊断,但缺乏明确特征表现,确诊需结合临床资料综合分析。 |
| 英文摘要: |
| Objective To analyze the MRI appearance of intramedullary spinal cord metastasis (ISCM) and the difference between ISCM and other common tumors of inner spinal cord for improving the knowledge of the disease. Methods Eleven cases of ISCM were analyzed retrospectively. MR examinations including pre-contrast and Gd-DTPA enhancement were performed in all the cases. Results MRI appearance of 4 cases clinically and 7 cases pathologically proved were analyzed (average age of onset was 46.4±2.8 years). Multiple lesions occurred in 6 cases distributing in cervical cord, thoracic cord, conus or cauda equina. Mono-lesion occurred in 5 cases: 3 occurred in conus, 1 occurred in cervical cord, 1 occurred in the boundary of cervical cord and bulbus medullae. ISCM mainly displayed hypointensity or isointensity on T1WI and heterogeneousc hyperintensity on T2WI. On contrast study, all tumors showed marked enhancement, appearing patching, ring-shaped, mottling and nodosity enhancement. Affiliated signs included spinal cord thickening, peripheral edema, spinal cord cavity et al. Conclusion MRI can well demonstrate the inner structure and signal character of ISCM, identify the extension and development of lesion, thus can contribute the diagnosis and differential diagnosis; however ISCM have no characteristic manifestations on MRI, clinical data should be analyzed comprehensively to draw the final diagnosis. |
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