脊柱单纯硬膜外海绵状血管瘤MRI征象分析

目的探讨脊柱单纯硬膜外海绵状血管瘤(Pure spinal epidural cavernous hemangiomas,PSECHs)的MRI特征。方法回顾分析手术病理证实的8例PSECHs的临床资料及MRI征象。结果 8例患者中,位于颈胸段者2例,位于胸段者3例,位于胸腰段者2例,位于腰段者1例。7例均发生于硬膜囊背侧,1例发生于硬膜囊右侧。纺锤状形态者6例,结节状者2例。病灶信号强度在T1WI基本上呈等或略低信号,T2WI呈高或不均匀高信号;增强扫描病灶均匀强化及不均匀环状强化。2例病灶内可见斑点状短T1、稍长T2脂肪信号影。2例PSECHs伴血肿形成,血肿呈短T1、短T2信号。6例脊髓明显受压,轴位T1WI病灶呈"钳"包绕脊髓。结论PSECHs虽是少见肿瘤样病变,根据病变的定位、形态、信号强度及强化特征,结合临床资料,可作出较为准确的诊断。

Analysis of MRI Features of Pure Spinal Epidural Cavernous Hemangiomas

Objective To investigate the MRI characteristics of pure spinal epidural cavernous hemangiomas (PSECHs). Methods Clinical data and MRI signs of 8 patients with PSECHs confirmed by surgical pathology were retrospectively analyzed. Results Among the 8 patients, 2 with PSECHs in the cervicothoracic segments, 3 in the thoracic segments, 2 in the thoracolumbar segments, and 1 in the lumbar segments. Additionally, PSECHs occurred in the dorsal part of the dural sac in 7 patients, and in the right side of the dural sac in 1 patient. Moreover, PSECHs presented spindle morphology in 6 patients and nodular shape in 2 patients. The lesions showed isointensity or slightly low signal intensity on T1WI, and presented high or inhomogeneous high signal intensity on T2WI; enhancement scanning of the lesions demonstrated homogeneous enhancement and inhomogeneous ring-like enhancement. Furthermore, spotted short T1 and slightly long T2 fat signal shadows were detected in the lesions of 2 patients. PSECHs of 2 patients were accompanied with hematoma formation, showing short T1 and short T2 signals. Obvious compression on the spinal cord was found in 6 patients, and lesions on the axial T1WI presented a "pincer-like structure" wrapping around the spinal cord. Conclusion Although PSECHs are rare tumor-like lesions, they can be accurately diagnosed according to the location, morphology, signal intensity and enhancement characteristics of lesions combined with clinical data.