van der Sande J J, Kröger R, Boogerd W
Amsterdam Neurological Division, Netherlands Cancer Institute.
J Neurol Neurosurg Psychiatry. 1990 Nov;53(11):1001-3. doi: 10.1136/jnnp.53.11.1001.
In a prospective study, patients with known malignant disease who were suspected of having a spinal epidural metastasis, had myelography which was not confined to the clinically suspected site, but included at least the whole lumbar and thoracic spinal canal. Fifty four of the 106 myelograms revealed at least one epidural metastasis. Twelve of these 54 myelograms showed two separate lesions, and four myelograms showed three separate lesions. In all 16 cases with multiple lesions at least one of the lesions was asymptomatic at the time of the diagnosis. It is concluded that multiple spinal epidural metastases are of common occurrence and occur in about one third of the cases. This finding may have important clinical implications. Examination of the spinal canal for epidural metastases should not be confined to the clinically suspected site, but should include as extensive an area as possible of the spinal canal, whatever technique is to be used.
在一项前瞻性研究中，已知患有恶性疾病且怀疑有脊髓硬膜外转移的患者接受了脊髓造影检查，检查范围不限于临床怀疑的部位，而是至少包括整个腰椎和胸椎椎管。106例脊髓造影中有54例显示至少有一处硬膜外转移。这54例脊髓造影中有12例显示有两个独立的病灶，4例显示有三个独立的病灶。在所有16例有多个病灶的病例中，至少有一个病灶在诊断时无症状。得出的结论是，多发性脊髓硬膜外转移很常见，约占病例的三分之一。这一发现可能具有重要的临床意义。对椎管进行硬膜外转移检查时，不应局限于临床怀疑的部位，而应包括尽可能广泛的椎管区域，无论采用何种技术。
