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目的 探讨MRI对脊柱转移瘤的敏感性 ,以提高脊柱转移瘤MRI表现的认识。方法 回顾性分析 45例脊柱转移瘤的MRI表现 ,结合文献进行讨论。结果 45例中共累及 14 9节椎体 ,累及椎弓根 19例 3 2根 ,棘突及横突 7例 11处。椎体压缩呈盘状 8例 2 1节 ,呈楔状 7例 11节 ,病椎轻度膨胀 4例 ,有软组织肿块 18例 ,硬膜囊、脊髓受压 15例 ,脊髓受侵 2例。病椎信号均匀 2 8例 ,不均匀 17例。T1WI为明显低信号 15例 ,略低信号 2 7例 ,等信号 3例。T2 WI为明显高信号 17例 ,略高信号 2 5例 ,等信号 3例。增强 18例 ,病灶明显强化 11例 ,轻度强化 6例 ,不强化 1例。软组织肿块边缘水肿、受压和受侵脊髓在MRI上均显示阳性。结论 MRI检查脊柱转移瘤的敏感性明显优于CT和X线平片 ,尤其肿瘤浸润椎骨尚属水肿、出血、坏死阶段时。
Objective To investigate the sensitivity of MRI to spinal metastases to improve the MRI findings of spinal metastases. Methods The MRI findings of 45 cases of spinal metastases were retrospectively analyzed and discussed in the literature. Results Forty-five patients involved 149 vertebral bodies, involving 32 pedicles in 19 cases, 11 cases of spinous processes and transverse processes in 7 cases. Vertebral compression was disk-like 8 cases of 21, was wedge-shaped in 7 cases in section 11, the mild vertebral expansion in 4 cases, 18 cases of soft tissue mass, dural sac, spinal cord compression in 15 cases, 2 cases of spinal cord involvement. 28 cases of uniform vertebral signal, uneven in 17 cases. T1WI was significantly lower signal in 15 cases, slightly lower signal in 27 cases, and other signals in 3 cases. T2 WI was significantly higher in 17 cases, slightly higher in 25 cases, and so on in 3 cases. In 18 cases, the lesions were significantly enhanced in 11 cases, mild enhancement in 6 cases and no enhancement in 1 case. Edema at the margin of soft tissue mass, compression and invasion of the spinal cord showed positive on MRI. Conclusion The sensitivity of MRI in detecting spinal metastases is obviously superior to that of CT and plain radiographs, especially when the infiltrating vertebrae of the tumor are still in edema, hemorrhage and necrosis stage.