复发性棘球蚴病的磁共振成像特征

Fei Wang, Jinying Wang, Hui Tian, Xin Gao, Hui Xing, Jian Wang
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摘要

目的:回顾性探讨复发性棘球蚴病的磁共振成像(MRI)特征,并区分复发性棘球蚴病与原发性棘球蚴病的MRI特征。材料与方法:选取2014年7月至2018年1月经手术及病理诊断的脊髓包虫病患者19例。9例术后复发,影像学及临床资料完整。结果:与原发性棘球蚴病的MRI表现相比,术后棘球蚴病复发的MRI表现为:大部分原发病灶的典型特征消失,病灶周围无明显外膜包裹,T2WI上可见高强度信号“小囊泡”。大多数囊泡未见明显的葡萄束样改变,无典型的多囊结构。椎体骨破坏区域及周围软组织结构不清,T1WI、T2WI未见低信号弧形钙化。复发性病变多表现为多发病灶,且彼此距离较远,多发病灶形成的单簇性病变并不多见。椎间盘受累是一种长期的破坏性特征。结论:棘包虫病术后复发MRI表现突出,可为棘包虫病术后复发提供更全面、可靠的影像学诊断依据。
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Magnetic resonance imaging features of recurrent spinal hydatidosis
OBJECTIVE: The objective of the study is to retrospectively investigate the magnetic resonance imaging (MRI) features of recurrent spinal hydatidosis and distinguish the MRI features between recurrent spinal hydatidosis and primary spinal hydatidosis. MATERIALS AND METHODS: Nineteen patients with spinal hydatidosis disease who underwent surgery and pathological diagnosis from July 2014 to January 2018 were selected. Nine cases recurred postoperatively and had complete imaging and clinical data. RESULTS: Compared with the MRI features of primary spinal hydatidosis, the MRI features of postoperative recurrence of spinal hydatidosis were as follows: most of the typical features of the primary lesion disappeared, with no obvious outer membrane wrapped around the lesion, and high-intensity signal “small vesicles” were seen on T2-weighted image (T2WI). Most vesicles had no obvious “grape-bunch”-like change and no typical polycystic structures. The vertebral bone destruction area and surrounding soft tissue structures were unclear, and there was no low-signal arc-like calcification on T1WI and T2WI. Recurrent lesions usually appeared as multiple lesions with significant distance from each other, and single clusters formed by multiple lesions were uncommon. Intervertebral disc involvement is a long-term destructive feature. CONCLUSION: Postoperative recurrence of spinal hydatidosis has prominent MRI features, which can provide a more comprehensive and reliable imaging diagnosis basis for postoperative recurrence of spinal hydatidosis.
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