MRI鉴别诊断椎管内结核瘤_转移性肿瘤及神经纤维瘤病.pdf

702中国医学影像技术2011年第27卷第4期ChinJMedImagingTechnol,2011,Vol27,No4

中枢神经影像学

MRIindiagnosisanddifferentialdiagnosisofintraspinal
tuberculoma,metastasisandneurofibromatosis

PENGJuan,LUOTianyou*,LVFajin,FANGWeidong,OUYANGYu,WUJingquan
(DepartmentofRadiology,theFirstAffiliatedHospital,Chongqing
MedicalUniversity,Chongqing400016,China)

[Abstract]ObjectiveToexploretheMRIfeaturesandtheirvalueindiagnosisanddifferentialdiagnosisofintraspinaltu
berculoma,metastasisandneurofibromatosis.MethodsMRIandclinicaldataof21patientswithclinicallyprovedintraspi
nallesionswereanalyzedretrospectively,includingintraspinaltuberculoma(n=8),metastasis(n=10)andneurofibroma
tosis(n=3).MRplanescanwasperformedinallpatients,whileenhancedscanwasperformedin20patients.Results
Theintraspinaltuberculomasandmetastasesinvolvedbothintraandextramedullary,locatingincervical,thoracic,and
lumbarsegments,mainlyinthesubduralspace.Theintraspinalneurofibromatosesmainlylocatedinlumbarsegments
aroundthecaudaequina,whilefewlesionswereseenonthesurfaceofcervicalandthoraciccord.Allthepatientspresented
asmultiplenodules,carryingisointensityonT1WIandisoorslightlyhyperintensityonT2WIwithmarkedenhancement
oncontrastenhancedimaging.Someintraspinaltuberculomasrevealedunclearborders,closelyconnectedwithspinaldura
materwhichobviouslythickenedandintensified,variablelamellarabnormalsignalsweredetectedwithinspinalcord,and
thickenedandintensifiedcaudaequinewasfoundin5patients.Theintraspinalmetastaseswerewellcircumscribedwithno
evidenceoffusionwhenspinalduraslightlyandmoderatelyenhancementwerenoticedin8patientsandvariablelamellarab
normalsignalswereseenin10patients,whilethickenedandintensifiedcaudaequinawasfoundin2patients.Theintraspi
nalneurofibromatoseswerewelldefined,withoutspinalduramaterorcaudaequinathickenedorenhanced,andnoabnor
malsignalinspinalcordwasshowed.ConclusionCombinedwithclinicaldata,MRIisquiteeffectiveindifferentiatingin
traspinaltuberculomafrommetastasisandneurofibromatosis.
[Keywords]Intrasp