Do-Dai Daniel D, Brooks Michael K, Goldkamp Allison, Erbay Sami, Bhadelia Rafeeque A
Department of Radiology, Tufts Medical Center, Boston, MA, USA.
Curr Probl Diagn Radiol. 2010 Jul-Aug;39(4):160-85. doi: 10.1067/j.cpradiol.2009.05.004.
Magnetic resonance imaging is the current imaging modality of choice in the evaluation of patients presenting with myelopathic symptoms in the search for spinal cord lesions. It is important for the radiologist to recognize and differentiate nonneoplastic from the neoplastic process of the spinal cord as the differentiation of the 2 entities is extremely crucial to the neurosurgeon. This article presents a broad spectrum of benign intramedullary spinal abnormalities including syrinx, contusion, abscess, infarction, myelitis, multiple sclerosis, sarcoid, cavernoma, and arteriovenous malformation. Rare intramedullary neoplasms including dermoid tumor, astrocytoma, ependymoma, hemangioblastoma, lymphoma, ganglioneuroblastoma, and metastases are also illustrated. The clinical presentation and magnetic resonance signal characteristics as well as the differential diagnosis of the intramedullary lesions are discussed. The potential pitfalls in the differentiation of tumors from nonneoplastic disease of the spinal cord are also elucidated.
磁共振成像（MRI）是目前用于评估出现脊髓病症状患者以寻找脊髓病变的首选成像方式。对于放射科医生而言，识别并区分脊髓的非肿瘤性病变与肿瘤性病变非常重要，因为区分这两种情况对神经外科医生极为关键。本文展示了广泛的良性脊髓内异常，包括脊髓空洞症、挫伤、脓肿、梗死、脊髓炎、多发性硬化、结节病、海绵状血管瘤和动静脉畸形。还展示了罕见的脊髓内肿瘤，包括皮样肿瘤、星形细胞瘤、室管膜瘤、血管母细胞瘤、淋巴瘤、神经节神经母细胞瘤和转移瘤。讨论了这些脊髓内病变的临床表现、磁共振信号特征以及鉴别诊断。还阐明了在区分脊髓肿瘤性疾病与非肿瘤性疾病时可能出现的陷阱。
