胸椎椎管内罗萨伊-多尔夫曼病1例
Chinese Journal of Medical Imaging Technology（2021）
Abstract
患者男,29岁,因"无明显诱因胸背部疼痛伴双下肢乏力2月余"入院;既往体健.查体:双侧乳头平面以下感觉减退,双下肢肌力4级,肌张力增高.实验室检查:红细胞沉降率53 mm/h.胸椎CT:T2～T5水平椎管内可疑软组织密度影,邻近骨质未见明显破坏,考虑肿瘤性病变.胸椎MRI:T3～T6水平椎管内见条带状等T1等T2信号,短时反转恢复序列(short TI inversion recovery,STIR)-T2WI 呈混杂稍高信号,并见轻中度均匀强化,边界欠清,累及硬膜囊壁和左侧椎间孔,相邻椎体见斑片状异常信号(图1A～1C);考虑胸椎管恶性肿瘤性病变可能性大,淋巴瘤?血液系统恶性肿瘤?行胸椎管内占位性病变切除+椎弓根螺钉内固定术,打开椎管见局部硬膜张力高,显微镜下探查见病变位于硬脊膜前方,约2 cm×1 cm×1 cm,质韧,血供中等,与硬脊膜紧密粘连.
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