脊柱转移瘤的低场mri诊断.docVIP

脊柱转移瘤的低场MRI诊断 作者：曹建新，陶伟，王一民，郑运祥 【摘要】 目的：探讨脊柱转移瘤的低场MRI诊断价值。方法：分析经临床或病理证实的脊柱转移瘤的MRI表现。结果：38例转移瘤共涉及166个椎体，单发转移5例，多发转移33例，其中呈跳跃式分布22例。134个受累椎体呈长T1长T2信号，27个呈长T1短T2信号，5个椎体T1WI为低信号，T2WI上为混杂信号，STIR上139个受累椎体见高信号。合并压缩性骨折椎体数21个，合并椎旁软组织肿块15例，合并附件转移14例，无一例出现椎间盘受累征像。18例行增强扫描时，受累椎体、附件及相邻的软组织肿块均见轻—中度强化。结论：在低场强磁共振上脊柱转移瘤具有特征性表现，能有助于早期诊断与鉴别诊断。 【关键词】 脊柱转移瘤；磁共振成像；诊断 　　Lowfield Intensity MRI Diagnosis of Spinal Metastasis 　　Abstract：Objective To study the value of lowfield MRI in diagnosis of spinal metastasis.Methods Clinically or pathologically proved spinal metastasis were applied to this study.Results In 38 cases,MRI has detected total 166 vertebral bodies metastase ,5 cases with single vertebral body metastase ,33 cases with multimetastase and 22 cases appeared jump sign.MR has detected 134 vertebral bodies metastase appeared low signal intensity on T1weighted images and high signal intensity on T2weighted images,27 vertehral bodies metastase appeared low signal intensity on T1weighted images and medium signal intensity on T2weighted images, 5 vertebral bodies metastases appeared low signal intensity on T1weighted images and mixture signal intensity on T2weighted images ,and 139 vertebral bodies metastase appeared high signal intensity on STIR. 21 vertebral bodies appeared compression fracture,15 cases appeared mass in paravertebral soft tissue,14 cases appeared annes to vertebral body invaded ,and no interverbral disc was invaded. In the 38 cases,18 cases were contrasted with GDDTPA,and show the vertebral bodies, annes to vertebral body and paravertebral soft tissue masses slightly or moderately enhanced.Conclusion The spinal mestastasison lowfield MR has characteristic sign, which can be used to diagnosis and different diagnosis of spinal metastasis. 　　Key words：Spinal metastasis;MRI; Diagnosis 　　脊柱转移瘤是临床上非常常见的转移性肿瘤，其发病率仅次于肺和肝脏的转移瘤，居第3位［1］。肿瘤好发于富含红骨髓的骨松质部分，不少患者首先以颈、胸、腰痛等症状来医院就诊。因此，早期诊断对积极治疗和预防发生并发症有着非常重要的意义，随着MR的问世，脊柱转移瘤