硬膜外血管脂肪瘤的MRI表现：1例病例汇报

MRI Presentation of Epidural Angiolipoma: A Case Report

摘要: 患者，女，61岁，主诉腰酸困双下肢坠胀半年，加重2月，专科查体发现椎旁双侧椎旁叩击痛阳性，双下肢屈肌及伸肌感觉减退；胸腰椎MRI平扫示：胸12-腰1椎体节段左侧椎间孔走行区见团片状稍短T1稍长T2信号影，界欠清，形态欠规整，大小约：1.1 cm × 1.0 cm × 2.5 cm，临近脊髓受压向右移位，压脂序列上见病变内小斑点状的信号减低，周围椎旁软组织内见斑片状压脂高信号影，增强扫描病变整体呈明显强化，其内见小斑点状无强化区域；MRI诊断：海绵状血管瘤，神经源性肿瘤不除外；术后病理诊断：胸12-腰1神经根管血管脂肪瘤。

Abstract: A 61-year-old female patient complained of lumbar soreness and swelling of both lower limbs for half a year, which aggravated for 2 months. Physical examination revealed positive bilateral para-vertebral percussion pain and hypoesthesia of flexor and extensor muscles of both lower limbs. Thoracolumbar MRI plain scan showed that the left intervertebral foramen of the thoracic 12-lumbar 1 segment was slightly short T1 and slightly long T2 signal shadow, the boundary was not clear, the shape was not regular, and the size of the lesion was 1.1 cm × 1.0 cm × 2.5 cm, and the adjacent spinal cord was compressed and shifted to the right. On the fat-suppression sequence, small speckle-like signal intensity was reduced in the lesion, and patchy fat-suppression high signal intensity was seen in the surrounding paravertebral soft tissue and the whole lesion showed obvi-ous enhancement on contrast-enhanced scan, and there were small speckle-like areas without en-hancement. MRI diagnosis: cavernous hemangioma, neurogenic tumor could not be excluded; Postoperative pathological diagnosis was thoracic 12-lumbar 1 nerve root canal angiolipoma.