【摘要】 目的探讨椎体淋巴瘤MRI及正电子发射体层成像(PET)的影像特征及临床应用价值。资料与方法回顾性分析经病理证实的15例椎体淋巴瘤患者的MRI和PET表现,原发性骨淋巴瘤6例,继发性9例。结果MRI:原发性6例均为单一椎体压缩性骨折伴局部硬膜外和/或椎体旁软组织肿块,软组织范围超过病变椎体;继发性9例均为多椎体压缩性改变,7例伴硬膜外和/或椎体旁软组织肿块。椎体病变T1WI呈等或混杂信号,T2WI呈稍高信号。软组织肿块T1WI呈等/低信号,T2WI呈稍高信号,明显均匀强化5例,轻度均匀强化8例。PET:原发性6例均为术后PET检查,1例术后2个月显示局部复发,5例无异常;继发性9例(术前6例、术后3例)PET显示多椎体、淋巴结及脾葡萄糖代谢异常增高。结论椎体原发性淋巴瘤多为单椎体病变;继发性常为多椎体受累,两者均可伴硬膜外和/或椎体旁软组织肿块。椎体淋巴瘤MRI、PET表现无特异性,MRI能清晰显示椎管内病灶与脊髓的关系,PET对鉴别原发性与继发性淋巴瘤有重要价值。更多还原

【Abstract】 Objective To explore the imaging features and value of MRI and PET for vertebral lymphoma.Materials and Methods A retrospective analysis was taken to assess the MR imaging and PET appearance of 15 cases with vertebral lymphoma confirmed by pathological results,including primary lymphoma of bone in 6 cases and secondary lymphoma of bone in 9 case.Results MR imaging findings included:6 cases of primary lymphoma of bone were demonstrated as solitary vertebral compression fracture with local epidural-and/or paravertebral soft tissue mass,and the range of soft tissue mass was larger than that of affected vertebrae;9 cases of secondary lymphoma of bone were demonstrated as multi-vertebral compression change,and 7 of 9 cases with epidural-and/or paravertebral soft tissue mass;the lesion of vertebrae showed iso-/heterogeneous intensity on T1WI,slightly hyperintensity on T2WI;soft tissue mass showed iso/hypointensity on T1WI,slightly hyperintensity on T2WI,with significantly homogeneous enhancement in 5 cases,and slightly homogeneous enhancement in 8 cases.PET findings included:6 cases of primary vertebral lymphoma received PET after operation,which local recurrence was in 1 case after 2 months,no abnormality in other 5 cases;6 case of secondary lymphoma of bone received PET before operation and 3 case after operation,which abnormally increased glycometabolism was in multi-vertebrae,lymphnodes and spleen.Conclusion Primary vertebral lymphoma is often solitary,secondary vertebral lymphoma often affect multiple vertebras,epidural-and/or paravertebral soft tissue mass can be found in both of them.The MR imaging and PET features of vertebral lymphoma is nonspecific,MR can delineate the intraspinal lesions and its relation with the spinal cord,and PET is of great value to differentiate primary from secondary vertebral lymphoma.更多还原