无症状性椎体血管瘤的磁共振随访研究

周晓航 陈莹 史凯文 陈梓玮 何丹云 丁洪伟

【摘要】目的：通过磁共振成像探讨无症状性椎体血管瘤（vertebral hemangiomas，VH）的转归可能，指导临床对无症状性椎体血管瘤的预防与治疗。方法：对160例既往通过磁共振诊断为椎体血管瘤患者再次行进行磁共振检查，根据既往磁共振影像将160例患者分为侵袭性VH115例，非侵袭性VH45例，对所有患者既往的磁共振及复查的磁共振影像矢状面T1加权、T2加权、脂肪抑制像进行回顾性分析。结果：115例原为侵袭性VH患者中84例复查磁共振后显示为非侵袭性，31例仍为侵袭性，45例原为非侵袭性VH患者中，复查磁共振后仍为非侵袭性43例，自愈2例。结论：侵袭性VH患者最终向非侵袭性进展（84/115，73.04%），并存在产生症状的可能（2/115，1.74%）。非侵袭性VH更趋于稳定，也不产生症状（43/45，95.56%），甚至有自愈的可能性（2/45， 4.44%）。这对临床上椎体血管瘤的疾病动态过程、预防及处理提供重要参考价值。

【关键词】椎体血管瘤;磁共振;侵袭性;无症状性

Magnetic resonance follow-up study of asymptomatic vertebral hemangioma

Magnetic resonance follow-up study of asymptomatic vertebral hemangioma

Zhou Xiaohang， Chen Ying， Shi Kaiwen， Chen Ziwei， He Danyun， Ding Hongwei*

Second affiliated hospital of nanjing university of traditional Chinese medicine，Nanjing 210017，China

[Abstract]

Objective：By MRI （mri） to investigate the asymptomatic vertebral hemangioma （VH） outcome may，to guide the prevention and treatment of asymptomatic vertebral hemangioma.Methods：MRI was performed again by 160 cases once diagnosed by MRI with vertebral hemangioma. According to the previous magnetic resonance image，the 160 patients were divided into 115 cases of aggressive VH and 45 cases of non-aggressive VH.All patients' previous and re-performed MRI were retrospectively analyzed on T1-weighted， T2-weighted and fat-suppressed MRI.Results：Of the 115 patients who were originally aggressive VH， 84 were non-aggressive after performing magnetic resonance reexamination again， and 31 were still aggressive.Among the 45 patients who were originally non-aggressive VH patients， 43 were still non-aggressive after performing magnetic resonance reexamination again， and 2 were self-healing.Conclusion：Patients with aggressive VH eventually progressed to non-aggressive progression （84/115，73.04%），with the possibility of symptom development （2/115， 1.74%）.Non-aggressive VH is more stable and asymptomatic （43/45， 95.56%）， and even self-healing （2/45， 4.44%）.This provides an important reference for the dynamic process， prevention and management of vertebral hemangioma.

[Key words] Vertebral hemangiomas（VH）;Magnetic resonance imaging（MRI）;Aggressive;Asymptomatic

【中圖分类号】

R395【文献标识码】

B 【文章编号】2095-6851（2020）05-255-01

血管瘤是良性的缓慢生长的血管肿瘤，可能发生在身体的任何地方，包括骨骼。根据临床表现可分为4类[1]：无症状无侵袭性，有症状无侵袭性，无症状有侵袭性，有症状有侵袭性。其中“侵袭性”血管瘤可以导致快速进行性脊髓压迫综合征。磁共振影像上，椎体血管瘤的T1、T2两种加权影像上表现多样，其不同主要取决于病灶内脂肪细胞、血管及间质水分的相对含量，本次研究中将病灶内血管及间质水分含量高于脂肪含量归于侵袭性，即T1加权为长或等信号，T2加权为长信号，脂肪抑制像为高信号。

根據我们的研究，侵袭性无症状性椎体血管瘤存在着产生症状的风险，临床上应加以重视，加强对该类患者的随访，而非侵袭性无症状性椎体血管瘤的病灶趋于稳定，产生症状的可能性很低，对此类患者的随访是不必要的。MRI也由于其特性成为椎体血管瘤分类的主要依赖手段。我们对产生症状的椎体血管瘤采取经皮球囊扩张椎体后凸成形术，术后患者症状缓解明显，疗效确切。

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