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白血病浸润硬脊膜并侵犯椎间孔的MRI表现分析

The MRI Appearances of Leukemia with Dura and Intervertebral Foramen Infiltration
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摘要 目的探讨白血病髓外浸润硬脊膜并侵犯椎间孔的MRI表现和鉴别诊断。方法回顾性分析经临床及病理证实的6例白血病侵犯椎间孔患者的MRI表现和临床资料;所有病灶行脊椎MRI扫描,其中5例行治疗前MRI平扫和增强扫描,1例行治疗前MRI平扫。结果 1例表现为颈椎旁、颈胸椎交界区硬膜下、硬膜外软组织肿块,多个右侧椎间孔肿块;4例表现为胸段硬膜外软组织肿块并侵犯单侧或双侧椎间孔,其中1例为右侧胸壁白血病浸润并通过椎间孔与椎管内硬膜外病灶沟通;1例为腰骶椎交界区硬膜外肿块并沿神经根侵及双侧椎间孔,硬膜囊被大部分包绕并受压变窄。4例病灶MRI平扫呈等或稍长T1、等或稍长T2信号,增强扫描呈均匀中度-显著强化;2例呈长T1不均匀长T2信号,增强扫描侵犯颈胸椎交界区病灶右侧椎间孔区病灶呈周边性强化,胸椎硬膜外病灶呈不均匀强化。结论白血病髓外浸润侵及椎管时胸段最易受累,最常见类型为膜外浸润,并常沿神经根向椎间孔侵犯。 Objective To evaluate the MRI appearances of Leukemia with dura and intervertebral foramina infiltration,as well as the MRI diagnosis and differential diagnosis. Methods MRI findings and clinical data of 6 cases of clinicallyproven or pathologically-confirmed Leukemia which invaded intervertebral foramina were retrospective analysed. All cases underwent MRI scans of the spine. 5 patients with both pre-contrast and post-contrast MRI scan,1 patient only accepted precontrast MRI examination before local treatment. Results 1 case located at cervicothoracic spine showed an irregular paravertebral tumor,as well as both extradural and subdural masses of right paraspinal region and some right intraforaminal tumors. 4 cases showed extradural masses of thoracic spinal as well as unilateral or bilateral intervertebral foramina involvement. 1 case of right chest wall leukemia infiltration communicates with the epidural lesions through the right intervertebral foramen. 1 case appeared as lumbosacral epidural tumor involved bilateral intervertebral foramina along the nerve roots,and dural sac was mostly wrapped and narrowed. 4 lesions presented almost iso-intensity or slight hypo-intensity to soft tissue on T1 WI and iso-intensity or slight hyperintensity on T2 WI,and after gadolinium injection,they all enhanced uniformly. Other2 cases showed slight hypointensity on T1 WI and heterogeneous hyperintensity on T2 WI,and inhomogeneous enhancement.Conclusion The thoracic spinal canal is the most vulnerable spinal canal of Leukemia extramedullary infiltration,and in which epidural infiltration is the most common type,furthermore,epidural lesions often involve intervertebral foramina along the nerve roots.
作者 李丹 吴珂 程敬亮 张勇 LI Dan;WU Ke;CHENG Jingliang(Department of MRI,Jiaozuo Municipal People’s Hospital,Jiaozuo,Henan Province 454100,P. R. China)
出处 《临床放射学杂志》 CSCD 北大核心 2019年第1期40-46,共7页 Journal of Clinical Radiology
关键词 白血病 髓外浸润 椎管内外 椎间孔 硬脊膜 Leukemia Extramedullary infiltration Intra-and extra-spinal Intervertebral foramen Dura
作者简介 通讯作者:吴珂。
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