Rodacki M A, Castro C E S, Castro D S
Ecomax-Diagnóstico por Imagem, Blumenau, Santa Catarina, Brazil.
Neuroradiology. 2005 May;47(5):316-21. doi: 10.1007/s00234-004-1262-7. Epub 2005 May 13.
We describe the case of a patient with a recent history of high back pain, with magnetic resonance imaging (MRI) of the thoracic spine showing intervertebral disk herniation into the spongious bone of the vertebral body of T9 that might have caused diffuse, low signal intensity on fluid-attenuated inversion recovery T1-weighted (FLAIR-T1W) images, high signal intensity magnetic resonance (MR) on T2-weighted (T2W) images and T2-weighted fat-suppressed images (T2W-FSIs) and marked enhancement on the vertebral body of T9 with gadolinium on T1-weighted fat-suppressed images (T1W-FSIs) images. Those findings suggested diffuse edema and might be indistinguishable from tumoral or inflammatory diseases, but the plain films and the reformatted sagittal computed tomography scans of the thoracic spine were helpful to show a calcified part of the intervertebral disk migrating into the vertebral body of T9. The patient made full recovery from the symptoms after conservative treatment and at the follow-up MRI showed normalization of the bone marrow signal intensity of the vertebral body of T9.
我们描述了一例近期有高位背痛病史的患者,胸椎磁共振成像(MRI)显示椎间盘疝入T9椎体的松质骨,这可能导致在液体衰减反转恢复T1加权(FLAIR-T1W)图像上出现弥漫性低信号强度、在T2加权(T2W)图像和T2加权脂肪抑制图像(T2W-FSI)上出现高信号强度磁共振(MR),以及在T1加权脂肪抑制图像(T1W-FSI)上钆增强T9椎体出现明显强化。这些发现提示弥漫性水肿,可能与肿瘤性或炎性疾病难以区分,但胸椎的平片和矢状位重建计算机断层扫描有助于显示椎间盘的钙化部分迁移至T9椎体。患者经保守治疗后症状完全缓解,随访MRI显示T9椎体骨髓信号强度恢复正常。