Takemoto K, Matsumura Y, Hashimoto H, Inoue Y, Fukuda T, Shakudo M, Nemoto Y, Onoyama Y, Yasui T, Hakuba A
Department of Radiology, Osaka City University Medical School, Japan.
Neuroradiology. 1988;30(4):303-9. doi: 10.1007/BF00328180.
Magnetic resonance (MR) images of 29 consecutive patients with intraspinal neoplasms (9 intramedullary tumors, 20 extramedullary tumors) were reviewed to evaluate the utility of MR imaging in distinguishing the intraspinal compartmental localisation and signal characteristics of each lesion. Compartment and histology of all neoplasms were surgically proven. MR correctly assigned one of three compartments to all lesions, 9 intramedullary, 14 intradural extramedullary (6 schwannomas, 3 neurofibromas, 5 meningiomas), and 6 extradural (3 schwannomas, 1 meningioma, 1 cavernous hemangioma, 1 metastatic renal cell carcinoma). All intramedullary tumors showed swelling of the spinal cord itself. In all five extradural tumors a low intensity band was visualized between the spinal cord and tumor. On the other hand, a low intensity band was demonstrated in no cases with intradural tumors. Visualization of this low intensity band is important in differentiating extradural from intradural-extramedullary lesions. We call this low intensity band, "the extradural sign". Signal intensity of intradural tumors varied with histology. In extramedullary tumors, signal intensity of schwannomas was similar to that of the cerebrospinal fluid (CSF) both on T1 weighted (inversion recovery) and T2 weighted spin echo (SE) images. On the other hand, meningiomas tended to be isointense to the spinal cord on both T1 and T2 weighted SE images. We found relatively reliable signal characteristics to discriminate meningioma from schwannoma.
回顾了29例连续的脊髓内肿瘤患者（9例髓内肿瘤，20例髓外肿瘤）的磁共振（MR）图像，以评估MR成像在区分每个病变的脊髓内定位和信号特征方面的效用。所有肿瘤的定位和组织学均经手术证实。MR正确地将所有病变归为三个定位之一，9例髓内病变，14例硬脊膜内髓外病变（6例神经鞘瘤，3例神经纤维瘤，5例脑膜瘤），6例硬脊膜外病变（3例神经鞘瘤，1例脑膜瘤，1例海绵状血管瘤，1例肾细胞癌转移瘤）。所有髓内肿瘤均显示脊髓本身肿胀。在所有5例硬脊膜外肿瘤中，脊髓与肿瘤之间可见一条低强度带。另一方面，硬脊膜内肿瘤无一例显示低强度带。这条低强度带的显示对于区分硬脊膜外病变与硬脊膜内髓外病变很重要。我们将这条低强度带称为“硬脊膜外征”。硬脊膜内肿瘤的信号强度因组织学而异。在髓外肿瘤中，神经鞘瘤在T1加权（反转恢复）和T2加权自旋回波（SE）图像上的信号强度与脑脊液（CSF）相似。另一方面，脑膜瘤在T1和T2加权SE图像上往往与脊髓等信号。我们发现了相对可靠的信号特征来区分脑膜瘤和神经鞘瘤。
