CAJ | 학술논문

目的探讨腰段椎管内硬膜外血管脂肪瘤的影像学表现，提高本病的影像学诊断水平。资料与方法回顾性分析经手术病理证实的4例腰椎管内血管脂肪瘤患者的 CT 及 MRI 资料，并分析病灶的形态、大小、部位、密度、信号等影像学特征。结果2例病灶位于椎管右前方，1例位于椎管左前方，1例位于椎管正后方；4例长轴平行于脊柱纵轴，均可见硬脊膜受压内移。4例 CT 均呈等低密度，最大径3~5 cm，密度均匀，边界清晰、光滑，内部未见钙化及坏死等，3例跨椎间孔生长，呈哑铃状，无邻近骨质吸收、破坏，1例呈扇贝样改变。4例 MRI 均呈稍长 T1WI、长 T2WI 信号，边缘清晰，STIR 序列呈高信号，内伴斑点状低信号，2例增强扫描后可见显著强化，1例可见脊膜尾征，1例两端呈笔尖样改变。结论 MRI 对椎管内血管脂肪瘤的定位及内部组织成分的鉴别具有重要价值，为目前诊断椎管内硬膜外血管脂肪瘤的“金标准”，CT 则提供良好的补充，CT 与 MRI 结合能提高椎管内血管脂肪瘤的诊断准确率。
목적탐토요단추관내경막외혈관지방류적영상학표현，제고본병적영상학진단수평。자료여방법회고성분석경수술병리증실적4례요추관내혈관지방류환자적 CT 급 MRI 자료，병분석병조적형태、대소、부위、밀도、신호등영상학특정。결과2례병조위우추관우전방，1례위우추관좌전방，1례위우추관정후방；4례장축평행우척주종축，균가견경척막수압내이。4례 CT 균정등저밀도，최대경3~5 cm，밀도균균，변계청석、광활，내부미견개화급배사등，3례과추간공생장，정아령상，무린근골질흡수、파배，1례정선패양개변。4례 MRI 균정초장 T1WI、장 T2WI 신호，변연청석，STIR 서렬정고신호，내반반점상저신호，2례증강소묘후가견현저강화，1례가견척막미정，1례량단정필첨양개변。결론 MRI 대추관내혈관지방류적정위급내부조직성분적감별구유중요개치，위목전진단추관내경막외혈관지방류적“금표준”，CT 칙제공량호적보충，CT 여 MRI 결합능제고추관내혈관지방류적진단준학솔。
Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.