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1、急性及亞急性脊髓髓內(nèi)病變MRI診斷與鑒別診斷思路脊髓病變良性病變脊髓空洞癥Ventriculusterminalis挫傷膿腫梗塞脊髓炎多發(fā)性硬化郝-伯二氏?。ㄈ鈽恿霾。﹦屿o脈的畸形占位性病變畸胎瘤星形細胞瘤室管膜瘤成血管細胞瘤淋巴瘤成神經(jīng)節(jié)細胞瘤轉移ThetypicalMRimagingprotocol forevaluationofthespinalcordlesionsunenhancedsagittalandaxialT1-weightedandT2-weightedimagespost-gadolinium-enhancedsagittalandaxialT1-weighted
2、images.ideallywithMRIoftheentirespine.Contrast-enhancedimagesarehelpfulindeterminingthesolidportionofanintramedullaryneoplasm,tumoralvsnontumoralcysts,otherenhancingpathologicentities,orotherfeaturesthatmaymodifythedifferentialdiagnosis.WHENITISANACUTEMYELOPATHY，WHATCAUSESSHOULDBECONSIDERED?Inpa
3、tientswithrecentonsetsymptoms,particularlyonesthatevolverapidly,theinitialpriorityistoexcludeasurgicalemergencysuchasepiduralmetastasisorabscess.immediateimagingisrequired,ideallywithMRIoftheentirespine.Ifimagingdemonstratesspinalcordcompressionduetoanacutelesionsuchasepiduralmetastasis,definiti
4、vemanagement(i.e.,surgery)shouldbepursuedwithoutdelaytopreventrapidandirreversibleworsening.一、與腫瘤有關SagittalT1-weightedMRimage(a)ofthethoracicspineillustratesdiffusemarrowhypointensityGadolinium-enhancedT1-weightedMRimage(b)depictsmultipleheterogeneouslyenhancinglesions(yellowarrows).TheSTIRMRima
5、ge(c)showsabnormallyincreasedsignalintheposteriorelementsandthevertebralbodies.Acompressionfractureisseenintheupperthoracicspine(redarrow).Epidurallymphoma. A62-year-oldmanwithknownhistoryoflymphomapresentswithprogressivebackpainandlowerextremityweaknessandparesthesias.SagittalandaxialT2(A,C)and
6、postcontrastT1(B,D)imagesdemonstrateanelongatedenhancingepiduralmass(longarrow)attheposterioraspectofthespinalcanalwithextensionintotheneuralforamina,causingcompressionanddisplacementofthethecalsacandspinalcordanteriorly.Ahypointensedura(arrowhead)isdisplacedanteriorly.Themassisinthesameposterio
7、repiduralspaceastheepiduralfat(shortarrow).Intradural-extramedullaryschwannoma.A55-year-oldpatientwithrightlowerextremityweakness.SagittalandaxialT2(A,D)andpre-(B,E)andpostcontrastT1(C,F)imagesdemonstratearelativelyhomogeneo
