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脊柱硬膜内神经鞘瘤:磁共振成像表现,重点关注增强特征

Intradural schwannomas of the spine: MR findings with emphasis on contrast-enhancement characteristics.

作者信息

Friedman D P, Tartaglino L M, Flanders A E

机构信息

Department of Radiology, Jefferson Medical College, Philadelphia, PA.

出版信息

AJR Am J Roentgenol. 1992 Jun;158(6):1347-50. doi: 10.2214/ajr.158.6.1590138.

Abstract

Intradural extramedullary schwannomas are nerve sheath neoplasms that consist of focal proliferations of Schwann cells involving a spinal nerve. We reviewed the MR findings in seven patients with pathologically proved intradural schwannomas. The contrast-enhancement characteristics on MR images were determined and compared with the histologic features of the tumor. Six lesions were variably hyperintense on T2-weighted images and one was uniformly hypointense compared with the signal intensity of the spinal cord. Signal on T1-weighted images ranged from hypointense to isointense. All seven tumors showed heterogeneous enhancement; in five, the enhancement involved only the periphery of the lesion. The pattern of enhancement did not correlate with the signal characteristics noted on unenhanced T1- and T2-weighted images. Pathologically, hyaline thickening of vessel walls and cyst formation were prevalent in the peripherally enhancing lesions. However, enhancement did not correlate with the relative proportion of Antoni type A and type B tissue. Recognition of the MR characteristics of intradural extramedullary schwannomas may be helpful in the differential diagnosis of spinal tumors. In particular, peripheral contrast enhancement of an intradural extramedullary tumor on MR images should suggest the diagnosis of schwannoma.

摘要

硬脊膜内髓外神经鞘瘤是由累及脊神经的施万细胞局灶性增生构成的神经鞘肿瘤。我们回顾了7例经病理证实的硬脊膜内神经鞘瘤患者的磁共振成像(MR)表现。确定了MR图像上的对比增强特征,并与肿瘤的组织学特征进行了比较。6个病灶在T2加权图像上呈不同程度的高信号,1个病灶与脊髓信号强度相比呈均匀低信号。T1加权图像上的信号强度从低信号到等信号不等。所有7个肿瘤均表现为不均匀强化;其中5个病灶仅周边强化。强化方式与未增强的T1加权和T2加权图像上的信号特征无关。病理上,血管壁透明样增厚和囊肿形成在周边强化的病灶中很常见。然而,强化与Antoni A型和B型组织的相对比例无关。认识硬脊膜内髓外神经鞘瘤的MR特征可能有助于脊髓肿瘤的鉴别诊断。特别是,MR图像上硬脊膜内髓外肿瘤的周边对比增强应提示神经鞘瘤的诊断。

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