Departments of Radiology, Peking University Third Hospital, Beijing, China.
Departments of Orthopaedics, Peking University Third Hospital, Beijing, China.
Br J Radiol. 2021 May 1;94(1121):20201250. doi: 10.1259/bjr.20201250. Epub 2021 Feb 26.
Symptomatic vertebral haemangioma (SVH) can present with atypical imaging features. Thus, this study analysed the imaging features of SVH using CT and MRI to improve SVH awareness.
We retrospectively analysed CT and MRI characteristics of 118 patients with clinically and pathologically confirmed SVH.
Overall, 118 patients were diagnosed with SVH, including 79 females and 39 males (mean age, 45.76 ± 16.36 years). The thoracic spine ( = 86) was the most common location of SVH, followed by the lumbar spine ( = 17). Involvement of multiple spinal segments was observed in 15 patients (12.71%). A total of 101 lesions (85.59%) were centred in the vertebral body, 15 lesions (12.71%) were centred in the posterior attachment, and two lesions (2%) were centred in the paraspinal region. CT showed 39 lesions (33.05%) without a typical honeycomb or polka-dot pattern. Compression fracture was observed in 23 patients (19.49%). Extraosseous extension was present in 111 patients (94.1%), and 17 lesions (14.41%) presented with foraminal extension. Epidural bony compression was observed in 46 patients (38.98%). 20 lesions (16.95%) had atypical weighted MRI signals, and 8 lesions (10.26%) showed atypical enhancement.
SVH was predominantly located in the thoracic spine. Involvement of multiple segments, posterior attachment localisation, absence of honeycomb or polka-dot signs, compression fracture, and atypical weighted imaging signals and enhancement were uncommon. Epidural bony compression was not uncommon and has important clinical significance.
The imaging features of SVHs are not fully understood. We examined the largest series of SVH cases reported to date.
症状性椎体血管瘤（SVH）可表现出非典型的影像学特征。因此，本研究通过 CT 和 MRI 分析 SVH 的影像学特征，以提高对 SVH 的认识。
我们回顾性分析了 118 例经临床和病理证实的 SVH 患者的 CT 和 MRI 特征。
共诊断 118 例 SVH 患者，其中女性 79 例，男性 39 例（平均年龄 45.76±16.36 岁）。SVH 最常见的部位是胸椎（ = 86），其次是腰椎（ = 17）。15 例患者（12.71%）存在多个脊柱节段受累。共 101 个病灶（85.59%）位于椎体中心，15 个病灶（12.71%）位于后附件，2 个病灶（2%）位于椎旁区。CT 显示 39 个病灶（33.05%）无典型的蜂巢或波尔卡点样模式。23 例患者（19.49%）出现压缩性骨折。111 例患者（94.1%）存在骨外延伸，17 个病灶（14.41%）出现椎间孔延伸。46 例患者（38.98%）存在硬膜外骨压迫。20 个病灶（16.95%）的 T2WI 信号不典型，8 个病灶（10.26%）增强后信号不典型。
SVH 主要位于胸椎。多节段受累、附件受累、无蜂巢或波尔卡点样征、压缩性骨折及 T2WI 信号和增强不典型、硬膜外骨压迫均不常见，但具有重要的临床意义。
SVH 的影像学特征尚未完全了解。我们检查了迄今为止报道的最大系列 SVH 病例。
