Li M H, Holtås S, Larsson E M
Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
Neuroradiology. 1993;35(5):370-4. doi: 10.1007/BF00588373.
Ninety-one patients with extradural spinal tumours were examined by magnetic resonance imaging. There were 76 metastases (6 from unknown primary tumours). Seven patients had primary spinal tumours and 8 had multiple myeloma. Sixteen had bulging, diseased vertebral bodies compressing the subarachnoid space and 67 had extradural tumour compressing the spinal cord. Sixty patients had paravertebral involvement. Intraspinal involvement did not correlate with the extent of spinal lesions. All patients had vertebral destruction, with hypointense or combined hypo- and isointense signal relative to bone marrow on T1-weighted images. In most of the 22 patients with T2-weighted images the tumours were isointense or slightly hyperintense. It was usually impossible to differentiate the various tumours on the basis of signal intensity and morphology. However, metastases from carcinoma of the prostate were often more hypointense than other tumours on T1- and T2-weighted images. An inhomogeneous pattern in which diffusely low signal is combined with focal lower signal on T1-weighted images may suggest myeloma. In the 22 patients examined with both T1- and T2-weighted images, T1-weighted images gave the best information in 18; in 3 they were equivalent and in 1 inferior to T2-weighted images; they are therefore recommended for routine imaging of epidural spinal tumours.
91例硬脊膜外脊柱肿瘤患者接受了磁共振成像检查。其中有76例转移瘤(6例原发肿瘤不明)。7例为原发性脊柱肿瘤,8例为多发性骨髓瘤。16例有椎体膨出、病变并压迫蛛网膜下腔,67例有硬脊膜外肿瘤压迫脊髓。60例有椎旁受累。脊髓内受累情况与脊柱病变范围无关。所有患者均有椎体破坏,在T1加权像上相对于骨髓呈低信号或低信号与等信号混合。在22例有T2加权像的患者中,大多数肿瘤呈等信号或稍高信号。通常无法根据信号强度和形态区分各种肿瘤。然而,前列腺癌转移瘤在T1加权像和T2加权像上往往比其他肿瘤信号更低。T1加权像上弥漫性低信号与局灶性更低信号相结合的不均匀模式可能提示骨髓瘤。在22例同时接受T1加权像和T2加权像检查的患者中,18例T1加权像提供的信息最佳;3例两者相当,1例T1加权像不如T2加权像;因此推荐T1加权像用于硬脊膜外脊柱肿瘤的常规成像。