目的探讨椎管内硬膜外血管脂肪瘤的 MRI 表现，提高对椎管内血管脂肪瘤的认识。资料与方法回顾性分析经手术病理证实的2例椎管内硬膜外血管脂肪瘤的 MRI 表现，并复习相关文献，依据 MRI 表现对其分型。结果2例椎管内硬膜外血管脂肪瘤分别位于腰椎椎管内和下段胸椎椎管内，肿瘤均位于硬膜外，呈长条形或梭形，长轴与脊柱纵轴平行。2例肿瘤部分区域在 T1WI 及 T2WI 上均呈高信号，压脂序列上信号衰减，增强扫描后相应区域强化不明显；部分区域在 T1WI 上呈低信号，T2WI 上呈高信号，压脂序列上信号无衰减，增强扫描后相应区域明显强化，故肿瘤在 T1WI 上呈高低混杂信号，T2WI 上呈高信号，压脂序列上肿瘤部分区域信号衰减，增强扫描后不均匀明显强化。MRI 表现分型，1例为 I 型，1例为 III 型；2例均为非浸润型。结论 MRI 能清楚显示椎管内硬膜外血管脂肪瘤的大小、形态、信号特征以及与椎管邻近结构的关系，MRI 分型可进一步提高对本病的认识，MRI是诊断本病的最佳影像学检查方法。%Purpose To investigate the MRI findings and to improve the understanding of spinal epidural angiolipomas. Materials and Methods MRI findings were retrospectively analyzed in two cases of surgery and pathology proven spinal epidural angiolipomas. Relevant literatures were reviewed. Results Two cases of spinal epidural angiolipomas were located in the lumber and lower thoracic spinal canal. The tumors were elongated or spindle in shape within the epidural space, and parallel to the longitudinal axis. In both cases part of the tumors were hyperintense on T1WI and T2WI, attenuated on fat-saturated sequences with mild enhancement. Some areas were hypointenseon T1WI, hyperintenseon T2WI, unattenuated on fat-saturated sequences with apparent enhancement. Angiolipomas were classified according to the MRI features. One was type I and the other was type III. Both cases were non-infiltrative. Conclusion MRI shows the size, shape, MRI signals and the association with the adjacent structure of spinal epidural angiolipomas. The MRI classification is helpful for improving the understanding of the tumor. MRI is the best imaging modality to diagnose spinal epidural angiolipomas.
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