Ashkenazi E, Pomeranz S, Floman Y
Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel.
J Spinal Disord. 1997 Oct;10(5):448-50.
A case of a large L3-L4 intervertebral disc herniation causing a widening of the intervertebral foramen is reported. There was a soft-tissue mas within the spinal canal and intervertebral foramen. The soft-tissue mass within the spinal canal and intervertebral foramen showed marked enhancement on magnetic resonance scans after injection of a paramagnetic contrast agent (Gd-DTPA). The combination of lesion configuration and paramagnetic contrast enhancement mimicked a spinal neurinoma. There exists a degree of overlap between the imaging of herniated discs and spinal neurinomas. When this overlap involves several aspects, such as anatomic configuration, mass enhancement, and secondary foraminal dilatation, the differential diagnosis between a herniated disc and a neurinoma may be problematic.
报告了一例因L3 - L4大型椎间盘突出导致椎间孔增宽的病例。椎管和椎间孔内存在软组织肿块。椎管和椎间孔内的软组织肿块在注射顺磁性造影剂(钆喷酸葡胺)后的磁共振扫描中显示出明显强化。病变形态和顺磁性造影剂强化的组合类似于脊髓神经鞘瘤。椎间盘突出和脊髓神经鞘瘤的影像学表现存在一定程度的重叠。当这种重叠涉及多个方面,如解剖形态、肿块强化和继发性椎间孔扩张时,椎间盘突出和神经鞘瘤之间的鉴别诊断可能存在问题。