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作者首次报道3例颅内成髓细胞瘤骨转移的MRI表现。例1,女,39岁,后颅凹成髓细胞瘤部分切除并放射治疗术后9个月,颈部肿大淋巴结活检为成髓细胞瘤转移,骨核素扫描及脊柱照片未见异常。经10个化学疗程后,因胸椎、左腿疼痛及排尿障碍,双足麻木行脊柱MRI检查,T_1象显示整个脊柱骨髓内多个局灶性低信号病灶,Gd-DTPA增强可见肿瘤沿整个脊髓和马尾的硬膜外扩散,增强后骨髓内病灶仍为低信号。CT及X线片提示骨的多发硬化性转移,活检显示脊膜弥散转移,脊髓内有水肿及坏死区,弥漫的骨转移还有肝的小转移灶。例2,男,32岁,后颅凹成髓细胞瘤并脑积水,行肿瘤边缘切除及脑室腹腔引流术,1年半后因全身衰弱和臂痛作MRI检查,颅顶及椎体骨髓T_1象信号减低,T_2象信号增强,髂嵴活检为成髓细胞瘤转移,类似原发瘤的肿瘤细胞取代造血
The authors first reported MRI findings of bone metastases in 3 cases of intracranial myeloblastoma. Example 1, female, 39 years old, 9 months after partial ablation and radiotherapy of posterior fossa myeloblastoma, a lymph node biopsy of the neck was metastatic with myeloid neoplasia. There were no abnormalities in radionuclide scans and spine photographs. After 10 cycles of chemotherapy, thoracic vertebrae, left leg pain, and micturition disorder, MRI of the spine with both feet numbness, T_1 images showing multiple low-intensity focal lesions in the bone marrow of the entire spine, Gd-DTPA enhanced visible tumors along the entire spinal cord Epidural diffusion of ponytail and horsetail, the bone marrow lesions remain low signal after enhancement. CT and X-ray films indicate multiple sclerotic metastases of bone, biopsy shows diffuse diffusion of the spinal cord, edema and necrosis within the spinal cord, diffuse bone metastases, and small metastases of the liver. Case 2, male, 32 years old, posterior fossa myeloblastoma with hydrocephalus, edge resection of the tumor and ventriculoperitoneal drainage, MRI examination of general weakness and arm pain 1 year and a half later, skull and vertebral bone marrow The T1 signal is reduced and the T2 signal is enhanced. The sputum biopsy is the metastasis of myeloblastoma. Tumor cells similar to the primary tumor replace hematopoiesis.