摘要
目的：评估增强后磁共振成像诊断椎管内神经瘤的特异性。材料和方法：对经外科手术的２０例椎管内神经瘤患者，回顾性比较分析病理和ＭＲＩ（包括Ｔ１加权成像、Ｔ２加权成像和静脉注射Ｇｄ－ＤＴＰＡ后Ｔ１加权成像）。结果：在Ｔ１加权像，与脊髓相比，呈均质低信号９例，不均质低信号１０例，不均质高信号１例；在Ｔ２加权像，２０例均示明显高信号（均质１３例，不均质７例）；静脉注射Ｇｄ－ＤＴＰＡ后Ｔ１加权成像，２０例均示明显强化，据其强化形态不同分为①均质强化８例；②明显不均质强化５例，病理上存在坏死囊变和陈旧性出血；③“煤渣状”不均质强化７例，病理上可能由不同量的ＡｎｔｏｎｉＡ和ＡｎｔｏｎｉＢ组织交互存在所造成或部分代表显微镜下见的微囊改变。结论：Ｔ１加权像呈低信号，Ｔ２加权呈明显的高信号，注射造影剂后出现明显的不均质强化和“煤渣状”不均质强化，是椎管内神经瘤的特征性ＭＲＩ征象。
Purpose:To evaluate the specifity of MRI in diagnosis of intra-spinal canal neuroma. Materials and Methods: The pathology and MR imaging(including T1-weighted images with intravenous injection of Gd-DTPA)of 20 patients with intraspinal canal neuroma surgicallly removed were respectively analyzed. Results: T1-weighted images showed homogeneous hypointensity relative to the cord in 9 cases,inhomogeneous iso-low signal intensites in 10 cases,and inhomogeneous high-low signal intensities in one case. T2-weighted images showed marked hyperintensity reative to the cord in all 20 cases (homogeneous in 13 case,inhomogeneous 7 cases).After intraveneous injecction of Gd-DTPA,all 20 tumors had marked enchancement,and three types of pattems were appeared: ①homogeneous enhancedment in 8 tumors,②marked heterogeneous enhancement in 5 cases which showed pathological necrosis,cyst formation and old hemorrhage within the tumors; ③heterogenous enhancement with a col-cinder pattem in 7 cases which were probably coexisted with various amount of Antoni type A and Antoni type B tissue, or partially represented microcystic degeneration within tumors on microscopy study. Conclusion: It is of characteristic MRI appearence of intraspinal canal neuroma that T1-weighted images had a low-signal intensity relative to the cord,T2- weighted images had a high-signal intensity,and T1-weighted images with injection of Gd-DYPA showed marked heterogenous enhancement and'coal-cinder pattern'enhancement.
出处
《中国医学计算机成像杂志》
CSCD
1996年第4期230-233,共4页
Chinese Computed Medical Imaging
