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目的探讨椎体淋巴瘤MRI及正电子发射体层成像(PET)的影像特征及临床应用价值。资料与方法回顾性分析经病理证实的15例椎体淋巴瘤患者的MRI和PET表现,原发性骨淋巴瘤6例,继发性9例。结果MRI:原发性6例均为单一椎体压缩性骨折伴局部硬膜外和/或椎体旁软组织肿块,软组织范围超过病变椎体;继发性9例均为多椎体压缩性改变,7例伴硬膜外和/或椎体旁软组织肿块。椎体病变T1WI呈等或混杂信号,T2WI呈稍高信号。软组织肿块T1WI呈等/低信号,T2WI呈稍高信号,明显均匀强化5例,轻度均匀强化8例。PET:原发性6例均为术后PET检查,1例术后2个月显示局部复发,5例无异常;继发性9例(术前6例、术后3例)PET显示多椎体、淋巴结及脾葡萄糖代谢异常增高。结论椎体原发性淋巴瘤多为单椎体病变;继发性常为多椎体受累,两者均可伴硬膜外和/或椎体旁软组织肿块。椎体淋巴瘤MRI、PET表现无特异性,MRI能清晰显示椎管内病灶与脊髓的关系,PET对鉴别原发性与继发性淋巴瘤有重要价值。
Objective To investigate the imaging features and clinical value of MRI and positron emission tomography (PET) of vertebral lymphoma. Materials and Methods Retrospective analysis of 15 cases of vertebral lymphoma confirmed by pathology MRI and PET findings, 6 cases of primary bone lymphoma, 9 cases of secondary. Results MRI: 6 cases of primary vertebral compression fractures with local epidural and / or paravertebral soft tissue mass, the soft tissue range over the lesion vertebral body; secondary 9 cases were multi-vertebral compression changes , 7 with epidural and / or paravertebral soft tissue mass. T1WI vertebral lesions were equal or mixed signal, T2WI was slightly higher signal. Soft tissue mass T1WI was equal / low signal, T2WI was slightly higher signal, significantly enhanced in 5 cases, mild uniform enhancement in 8 cases. PET: primary 6 cases were postoperative PET examination, 1 case showed local recurrence 2 months after operation, 5 cases no abnormal; secondary 9 cases (preoperative 6 cases, 3 cases after surgery) PET showed more vertebra Body, lymph node and spleen glucose metabolism increased. Conclusions Most of vertebral primary lymphoma are single vertebral body lesions. The secondary ones are usually multiple vertebral body involvement, both of which may be associated with epidural and / or paravertebral soft tissue mass. Vertebral lymphoma MRI, PET non-specific performance, MRI can clearly show the relationship between spinal cord lesions and spinal lesions, PET has important value in the identification of primary and secondary lymphoma.