腰椎管硬膜外血管脂肪瘤的CT与MRI表现

发布时间：2018-04-27 14:22

本文选题：血管脂瘤 + 硬膜外肿瘤　；参考：《中国医学影像学杂志》2015年06期

【摘要】：目的探讨腰段椎管内硬膜外血管脂肪瘤的影像学表现,提高本病的影像学诊断水平。资料与方法回顾性分析经手术病理证实的4例腰椎管内血管脂肪瘤患者的CT及MRI资料,并分析病灶的形态、大小、部位、密度、信号等影像学特征。结果 2例病灶位于椎管右前方,1例位于椎管左前方,1例位于椎管正后方;4例长轴平行于脊柱纵轴,均可见硬脊膜受压内移。4例CT均呈等低密度,最大径3~5 cm,密度均匀,边界清晰、光滑,内部未见钙化及坏死等,3例跨椎间孔生长,呈哑铃状,无邻近骨质吸收、破坏,1例呈扇贝样改变。4例MRI均呈稍长T1WI、长T2WI信号,边缘清晰,STIR序列呈高信号,内伴斑点状低信号,2例增强扫描后可见显著强化,1例可见脊膜尾征,1例两端呈笔尖样改变。结论 MRI对椎管内血管脂肪瘤的定位及内部组织成分的鉴别具有重要价值,为目前诊断椎管内硬膜外血管脂肪瘤的"金标准",CT则提供良好的补充,CT与MRI结合能提高椎管内血管脂肪瘤的诊断准确率。
[Abstract]:Objective to investigate the imaging features of lumbar spinal epidural angiolipoma and to improve the imaging diagnosis of the disease. Materials and methods CT and MRI findings of 4 patients with angiolipoma in the lumbar spinal canal proved by surgery and pathology were analyzed retrospectively. The imaging features of the lesions such as shape, size, location, density and signal were analyzed. Results in 2 cases, the lesions were located in the right anterior spinal canal. One case was located in the left anterior spinal canal. One case was located directly behind the spinal canal. In 4 cases, the long axis was parallel to the longitudinal axis of the spinal column. In all cases, the dural compression and internal displacement of 4 cases showed the same low density, the maximum diameter was 3 cm, and the density was uniform. The boundary was clear and smooth. There were no calcification and necrosis in 3 cases, which grew across intervertebral foramen with dumbbell shape, no adjacent bone absorption, and 1 case had scallop like changes in MRI. 4 cases showed slightly longer T1WI signal, long T2WI signal, and high signal intensity in edge clear stair sequence. In 2 cases with dot-like hypointensity, 1 case with meningeal caudal sign showed sharp enhancement and 1 case showed nib changes at both ends of the meninges. Conclusion MRI is of great value in the localization of intraspinal angiolipoma and the differentiation of internal tissue components. For the present diagnosis of intraspinal epidural angiolipoma "gold standard" CT provides a good complementary CT combined with MRI can improve the diagnostic accuracy of intraspinal angiolipoma.
【作者单位】：嘉兴市第一医院放射科;
【基金】：嘉兴市重点学科(04-F-01)
【分类号】：R739.4;R730.44;R445.2

【参考文献】