亚洲免费av电影一区二区三区,日韩爱爱视频,51精品视频一区二区三区,91视频爱爱,日韩欧美在线播放视频,中文字幕少妇AV,亚洲电影中文字幕,久久久久亚洲av成人网址,久久综合视频网站,国产在线不卡免费播放

        ?

        Vertebral Hemangioma 椎體海綿狀血管瘤

        2019-11-13 05:48:52Brant-ZawadzkiM,ChenMZ,MooreKR
        影像診斷與介入放射學(xué) 2019年5期
        關(guān)鍵詞:壓脂波點海綿狀

        Key Facts

        Definition: Benign vertebral body vascular tumor.

        Classic imaging appearance: Hypodense lesion (CT) with coarse, verticallyoriented trabeculae; hyperintense (MRI) on both T1WI and T2WI.

        Most common spinal axis tumor: (1) Incidental lesion identified on imaging performed for unrelated reasons.(2) Rarer presentation (clinical or radiographic) is “aggressive hemangioma”.

        Radiographic diagnostic criteria are lesion growth, bone destruction, vertebral collapse, absence of fat in lesion, and active vascular component.

        May extend epidurally and cause cord compression.

        CT Findings

        Best imaging clue: Well-circumscribed, hypodense lesion with coarse vertical trabeculae (“white polka dots”) on axial CT.

        Hypodense lesion centered in vertebral body.

        Sparse, thickened trabeculae surrounded by hypodense fat.

        “Spotted” appearance on axial images.

        Aggressive lesions show avid contrast enhancement.

        MR Findings

        Typical “benign” (fatty stroma) hemangioma: (1) T1WI--hyperintense, with avid contrast enhancement.(2) T2WI--hyperintense.(3) Occasional radiographically benign lesions are isointense or hypointense on T1WI, and difficult to distinguish from metastases.

        “Aggressive”(“malignant”) hemangioma: (1)T1WI--isointense to hypointense,with avid contrast enhancement.(2) T2WI--hyperintense.(3) Pathologic fracture or epidural extension common.(4) Clinically aggressive hemangiomas are usually radiographically aggressive as well.

        Other Modality Findings

        Plain film: Vertebral body lesion with coarse vertical trabeculae resembling corduroy.

        Angiography: Normal to hypervascular stain; aggressive lesions stain vividly.

        Imaging Recommendations

        Both CT and MR can permit a specific diagnosis.MR best demonstratesaggressive characteristics.Sagittal and axial T1WI images most useful to characterize composition.Axial T2WI and enhanced T1WI best for characterizing epidural extent and cord compromise (aggressive lesions).Axial bone algorithm CT is most useful for characteristic features that distinguish hemangioma from metastatic lesion.

        Angiography unnecessary unless embolization is being considered.

        醫(yī)學(xué)詞匯注釋與簡要講解

        vertebral 椎體的

        hemangioma 血管瘤

        trabeculae 骨小梁

        vertebral collapse 椎體塌陷

        epidural 硬膜外的

        polka dot 圓點、波點

        sparse 稀疏的

        stroma 基質(zhì)

        pedicles 椎弓根

        STIR sequence 短TI反轉(zhuǎn)恢復(fù)序列(壓脂)

        Stromata= stroma 基質(zhì)

        myelopathy 脊髓病變

        radiculopathy 神經(jīng)根病

        vertebroplasty 椎體成形術(shù)

        Fig 1 Typical (aggressive) hemangioma: a)~c)Axial CT shows a well-circumscribed T10 vertebral lesion with sparse, thickened trabeculae, destructive expansion into the epidural space and strong enhancement.d)Sagittal CT reconstruction.e)T1WI and f)T2WI show an iso-hyperintense T10 vertebral lesion with epidural expansion.

        Differential Diagnosis

        Vertebral metastases: (1) Characteristically extends into pedicles.(2) Hypointense on T1WI,hypointense to hyperintense(to marrow)on T2WI.(3)T1WI sequence helps distinguish from benign hemangioma.(4) May be difficult to distinguish from “vascular” or“agressive” hemangioma on CT.

        Focal Fatty Marrow: (1) Incidental rounded focus of marrow fat that is conspicuous on MRI.(2)STIR sequence will show marked lesion hypointensity.(3)Hemangiomas typically retain some high signal due to vascular components.

        Pathology

        General Path Comments: (1) Slow growing; (2) Capillary, cavernous or venous origin; (3) Cavernous hemangiomas most common.

        Epidemiology: (1) Common 10%-12% of adult population.(2) 25%-30%multiple; particularly in thoracic spine.(3) Peak incidence fourth to sixth decades.(4) Benign lesions M = F; aggressive lesions slightly more commonin women.

        Gross Pathologic-Surgical Features: (1) Vast majority confined to vertebral body proper.(2) May be small or occupy entire vertebral body.(3) Uncommonly involve posterior elements/pedicles (10%-15%).(4) Thoracic lesions are more often aggressive than at other locations.

        Microscopic Features: (1) Benign lesions show mature, thin-walled, endothelium-lined capillary and cavernous sinuses interspersed among sparse,osseous trabeculae and fatty stromata.(2) Aggressive lesions contain less fat and more vascular stromata.

        Clinical Issues

        Presentation: (1) Benign hemangiomas are incidentally discovered.(2) Symptomatic (aggressive) hemangiomas present with intense, localized spinal pain,myelopathy and/or radiculopathy from osseous expansion, pathologic fracture, and/or epidural extension.

        Treatment: (1) Benign (fatty) hemangiomas--no treatment necessary.(2)Aggressive hemangiomas--first-line therapy is vertebroplasty in conjunction with embolization and surgery as needed.

        Prognosis: (1) Benign (fatty) hemangiomas--incidental lesions, excellent prognosis.(2) Aggressive vascular hemangiomas--variable depending on size of lesion, degree of epidural extension, and presence/absence of cord compression.

        猜你喜歡
        壓脂波點海綿狀
        縱隔海綿狀血管瘤的影像學(xué)表現(xiàn)與病理對比分析(附4例報告)
        胸椎真菌感染誤診結(jié)核一例
        CT和核磁共振成像在顱內(nèi)海綿狀血管瘤的診斷效果觀察
        MR壓脂T2加權(quán)與彌散加權(quán)成像在合并肺不張的中心型肺癌中的應(yīng)用
        讓注意力到你身上來 波點的世界怎能錯過
        波點之美
        波點女孩
        頑趣波點
        Coco薇(2016年3期)2016-04-06 02:40:48
        MR壓脂T2WI/DWI及增強CT對肺癌與肺不張組織的顯像效果
        磁共振T2WI壓脂及T1WI壓脂增強序列在肛癰及肛漏診斷中的價值
        在线观看亚洲你懂得| 亚洲最大av网站在线观看| 夜先锋av资源网站| 香蕉视频一级| 亚洲综合久久久中文字幕| 国产饥渴的富婆一凶二区| 国产内射爽爽大片视频社区在线| 激情欧美日韩一区二区| 亚洲va在线va天堂va四虎| 青青草视频在线播放观看| 97久久婷婷五月综合色d啪蜜芽| 久久夜色精品国产噜噜亚洲av| 亚洲欧洲日产国码无码AV一| 最新日韩精品视频免费在线观看| 开心五月天第四色婷婷| 免费人妻无码不卡中文字幕18禁 | 久久精品久久精品中文字幕| 一区二区特别黄色大片| 日本视频一区二区三区在线观看| 亚洲av无码一区二区三区天堂古代 | 亚洲国产精品一区二区第一| 亚洲av一区二区三区蜜桃| 国产男女免费完整视频| 亚洲综合中文字幕乱码在线| 亚洲一区二区三区综合网| 国产一级一级内射视频| 国产sm调教视频在线观看| av无码精品一区二区乱子| 日本91一区二区不卡| 欧美激情一区二区三区成人| 一本大道东京热无码| 在线无码免费看黄网站| 日本一区二区三区四区高清不卡 | 国内精品福利在线视频| 极品美女高潮喷白浆视频| 精品国产一区二区三广区| 国产亚洲av无码av男人的天堂| 日韩一区av二区三区| 欧美日韩激情在线一区二区| 成年男人午夜视频在线看| 亚洲国产精品美女久久|