Department of MRI, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China.
Can Assoc Radiol J. 2013 Aug;64(3):240-5. doi: 10.1016/j.carj.2012.01.001. Epub 2012 May 9.
The purpose of our study was to describe the salient magnetic resonance imaging (MRI) findings in primary intraspinal peripheral primitive neuroectodermal tumour (PNET).
A retrospective review of the clinical and MRI images of 7 pathologically proven cases of intraspinal peripheral PNETs was performed. The various parameters, such as vertebral level of involvement; tumour location, size, focality, and margin; signal intensity of the lesion; the presence of hemorrhage or calcification; any signal voids; assessment of the adjacent cord for cord compression; cord dilatation; the presence of paraspinal tissue mass; or vertebral or other bony changes, were analysed.
All 7 patients had lesions in the thoracolumbar region. Three patients had extradural lesions, 4 had intradural extramedullary lesions, and none had intramedullary lesions. Six lesions were well circumscribed. Only 1 patient had multifocal involvement. All lesions were of hypointense or isointense signal on T1-weighted imaging, whereas all but one were hyperintense on T2-weighted imaging. Lesions enhanced heterogeneously except 1 intradural extramedullary lesion, which enhanced homogeneously. A paraspinal mass was noticed in 2 patients. Vertebral collapse was present in 1 patients.
Intraspinal peripheral PNETs are rare spinal tumours. Although imaging characteristics are not specific, a focal circumscribed lesion in a young individual at the intramedullary, extramedullary intradural, or extradural spinal location that shows hypointense and hyperintense signal on T1- and T2-weighted images, respectively, requires PNET to be considered in the differentials.
本研究的目的在于描述原发性脊髓外周原始神经外胚层肿瘤(PNET)的磁共振成像(MRI)特征。
回顾性分析 7 例经病理证实的脊髓外周 PNET 患者的临床和 MRI 图像。分析了各种参数,包括受累的椎骨水平;肿瘤的位置、大小、局灶性和边缘;病变的信号强度;是否存在出血或钙化;任何信号缺失;评估脊髓受压情况、脊髓扩张、是否存在椎旁软组织肿块或椎体或其他骨改变。
7 例患者的病变均位于胸腰椎区。3 例为硬膜外病变,4 例为硬脊膜外髓内病变,均无髓内病变。6 个病变为边界清楚。仅 1 例有多发病灶。所有病变在 T1 加权成像上呈低信号或等信号,而在 T2 加权成像上除 1 例外均呈高信号。除 1 例硬脊膜外髓内病变外,病变均呈不均匀强化。2 例患者发现椎旁肿块。1 例患者存在椎体塌陷。
脊髓外周 PNET 是罕见的脊髓肿瘤。尽管影像学特征不具有特异性,但在年轻个体中,位于脊髓内、硬脊膜外髓内、或硬脊膜外的局灶性、边界清楚的病变,在 T1 和 T2 加权图像上分别表现为低信号和高信号,需要考虑 PNET 作为鉴别诊断。