Takahashi M, Sakamoto Y, Kojima R, Yamashita Y, Bussaka H
Rinsho Hoshasen. 1989 Feb;34(2):191-8.
Exact localization of the spinal tumors is particularly important for differential diagnosis and surgery. Therefore, it was attempted to evaluate the diagnostic accuracy of MRI in localizing the spinal tumors exactly. Nineteen cases of spinal cord tumors, being localized in the intradural extramedullary, extradural and both intradural and extradural spaces, were studied with MRI. Intradural extramedullary tumors showed small CSF spaces just below and above the tumor which were demonstrated as CSF intensity on T1 and T2 weighted images. Although extradural tumors did not show CSF spaces, there was extradural sign or dural density between the tumor and the spinal cord. Intradural and extradural tumors were outlined as having both characteristics. Signal intensities of the spinal tumors were not characteristic for specific histology. Gd-DTPA was quite useful for accurate localization of the tumors. In comparison with myelography, MRI was superior to myelography in extradural tumors and equally useful for intradural and extradural tumors, but it was less diagnostic in intradural extramedullary tumors. In general, MRI was quite useful in localizing the spinal tumors exactly and the accuracy of MRI was quite high. In the near future this technique will replace myelography and other radiologic methods.
脊髓肿瘤的精确定位对于鉴别诊断和手术尤为重要。因此,人们试图评估MRI在精确确定脊髓肿瘤位置方面的诊断准确性。对19例脊髓肿瘤患者进行了MRI研究,这些肿瘤分别位于硬膜内髓外、硬膜外以及硬膜内和硬膜外间隙。硬膜内髓外肿瘤在肿瘤上下方显示小的脑脊液间隙,在T1加权像和T2加权像上呈脑脊液信号强度。虽然硬膜外肿瘤未显示脑脊液间隙,但在肿瘤与脊髓之间有硬膜外征或硬膜密度。硬膜内和硬膜外肿瘤则兼具两者特征。脊髓肿瘤的信号强度对特定组织学无特征性表现。钆喷酸葡胺对肿瘤的准确定位非常有用。与脊髓造影相比,MRI在硬膜外肿瘤方面优于脊髓造影,对硬膜内和硬膜外肿瘤同样有用,但在硬膜内髓外肿瘤方面诊断价值较小。总体而言,MRI在精确确定脊髓肿瘤位置方面非常有用,其准确性相当高。在不久的将来,这项技术将取代脊髓造影和其他放射学方法。