常见脊髓非肿瘤性病变的MRI 诊断及鉴别诊断.pdfVIP

作者简介:包发秀(1989- ),女,青海省互助县人,在读硕士。研究 方向:中枢神经系统影像学诊断。 通信作者:张 明,E-mail:zmmri@1 6 3.com 常见脊髓非肿瘤性病变的 MRI 诊断及鉴别诊断 包发秀,王 渊,代 勤,毛翠平,王红梅,郭丽萍,李文菲,张 明 (西安交通大学医学院第一附属医院影像科,陕西 西安 71006 1) 摘要:目的 分析常见脊髓非肿瘤性病变的 MRI 表现及鉴别诊断要点。方法 回顾性分析本院 28 例脊髓非肿瘤性病变的临 床和 MRI 资料,总结其 MRI 特征。结果 28 例患者中急性脊髓炎 5 例、脊髓多发性硬化 1 6 例、视神经脊髓炎 4 例、脊髓亚急性联 合变性 1 例、脊髓梗死 2 例。所有病例 MRI 信号相似,均为 T1WI 等或稍低、T2WI 高信号,急性脊髓炎常累及 5 个以上椎体节段, 脊髓均匀性肿胀;脊髓多发性硬化受累范围一般2 个椎体节段,病变小于横截面积的 1/2;视神经脊髓炎累及 3 个以上椎体节段, 累及大部分灰质和部分白质;脊髓亚急性联合变性病变位于脊髓后部,轴位 T2 显示对称性分布于后索或侧索;脊髓梗死可累及 1 至数个椎体节段,局限在脊髓前 2/3 区域,形成“猫头鹰眼征”。结论 常见脊髓非肿瘤性病变的 MRI 表现有一定特征性,结合病 变的形态、累及范围及临床资料有助于定性诊断。 关键词:磁共振成像;急性脊髓炎;脊髓多发性硬化;视神经脊髓炎;脊髓亚急性联合变性;脊髓梗死 DOI:10.39 6 9/j.issn.1002-1 6 7 1.2014.06.002 中图分类号:R445.2;R745.4 文献标志码:A 文章编号:1 002-1 6 7 1(20 1 4)06-090 1-04 MR imaging diagnosis and differential diagnosis of routine non-neoplastic lesions in the spinal cord BAO Faxiu,WANG Yuan,DAI Qin,MAO Cuiping,WANG Hongmei, GUO Liping,LI Wenfei,ZHANG Ming (Department of Radiology,the First Affiliated Hospital,Medical College of Xi’an J iaotong University,Xi’an 7 1 006 1,China) Abstract:Objective To analyze magnetic resonance imaging (MRI)features and differential diagnosis of non-neoplastic lesions in the spinal cord.Methods Clinical manifestations and MRI data of 28 patients with non-neoplastic lesions in the spinal cord were analyzed retrospectively.Results Of the 28 cases,5 cases were acute myelitis,1 6 were multiple sclerosis,4 were neuromyelitis op- tica,1 case was subacute combined degeneration of spinal cord and 2 cases were spinal cord infarction.The MR signal intensity of the spinal cord lesions in all patients are similar presenting as isointensity or slight hypointensity on T1 weighted images and hyperinten- sity on T2 weighted images.In our study,both gray matter and white matter were involved in acute myelitis and the size is about more than 5 vertebral segments.For multiple sclerosis,the lesions were less than 2 vertebral segments in length and occupy 1/2 of the spinal cord in