Rovira A, Rovira A, Capellades J, Zauner M, Bella R, Rovira M
Servei de Diagnòstic per Imatge, Consorci Hospitalari del Parc Taulí, Sabadell, Spain.
AJNR Am J Neuroradiol. 1999 Jan;20(1):27-31.
The CT, MR, and histologic findings of three patients with surgically proved lumbar extradural cavernous and arteriovenous hemangiomas are reported. All three patients suffered from radicular and low back pain that disappeared completely or nearly so after total surgical excision. In each case, neuroimaging studies showed a well-defined ventrally located extradural mass with no bone involvement. On MR images, all lesions were homogeneous and isointense on noncontrast T1-weighted images and hyperintense on T2-weighted images relative to the intervertebral disk. Homogeneous enhancement was seen in one of the two cases in which contrast-enhanced T1-weighted images were obtained. Purely extradural hemangiomas should be included in the differential diagnosis of lumbar extradural soft-tissue lesions. Features that may help to distinguish this entity from the more common extruded disk herniation or neurogenic tumors are its homogeneous high signal intensity on T2-weighted images, ovoid shape, and lack of anatomic relationship with the adjacent intervertebral disk or exiting nerve root.
报告了3例经手术证实的腰椎硬膜外海绵状血管瘤和动静脉血管瘤患者的CT、MR及组织学检查结果。所有3例患者均有神经根性和下腰痛，在手术全切后疼痛完全或几乎完全消失。每例患者的神经影像学检查均显示硬膜外有边界清晰的腹侧肿块，无骨质受累。在MR图像上，所有病变在非增强T1加权图像上均呈均匀等信号，相对于椎间盘在T2加权图像上呈高信号。在2例进行了增强T1加权成像的病例中，有1例可见均匀强化。腰椎硬膜外软组织病变的鉴别诊断应包括单纯硬膜外血管瘤。有助于将该病变与更常见的椎间盘突出或神经源性肿瘤相鉴别的特征包括：在T2加权图像上呈均匀高信号强度、椭圆形以及与相邻椎间盘或穿出神经根无解剖关系。
