UNASSIGNED: The clinical and MRI data of 24 child patients with intraspinal tuberculoma (such as 6 cases of intramedullary tuberculoma, 8 cases of intradural extramedullary tuberculoma, and 10 cases of epidural tuberculoma) were retrospectively analyzed. All patients underwent plain and contrast-enhanced MR scans. The diagnosis was confirmed by surgical pathology or by antituberculous treatment and follow-up data.
UNASSIGNED: Intramedullary tuberculoma had a round shape, while intradural extramedullary tuberculoma and epidural tuberculoma presented long-fusiform or en plaque shapes. Regarding MRI signals, intramedullary tuberculoma and extramedullary tuberculoma were mainly isointense on T1-weighted imaging (T1WI) and hypointense or isointense on T2WI. Rim enhancement was observed in intramedullary tuberculoma, and marked homogeneous enhancement was dominant in extramedullary tuberculoma. Ten (10/24) tuberculomas occurred during antituberculous therapy, with intradural extramedullary tuberculoma accounting for 7 cases (7/8), which was significantly more frequent than intramedullary tuberculoma (1/6) or epidural tuberculoma (2/10).
UNASSIGNED: MRI is important in the diagnosis of intraspinal tuberculoma, which is characterized by isointensity on T1WI, isointensity, or hypointensity on T2WI, and rim or obvious homogeneous enhancement. Some intraspinal tuberculomas, especially intradural extramedullary tuberculomas, might be associated with the \"paradoxical response\" mechanism during the tuberculosis treatment.
■24例儿童椎管内结核瘤的临床和MRI资料(例如6例髓内结核瘤,硬膜内髓外结核瘤8例,回顾性分析10例硬膜外结核瘤)。所有患者均接受平扫和对比增强MR扫描。诊断经手术病理或抗结核治疗及随访资料证实。
■髓内结核瘤呈圆形,硬膜内髓外结核瘤和硬膜外结核瘤呈长梭形或斑块状。关于MRI信号,髓内结核瘤和髓外结核瘤在T1加权成像(T1WI)上主要是等信号,在T2WI上是低信号或等信号。在髓内结核瘤中观察到边缘增强,并且在髓外结核瘤中以明显的均匀增强为主。在抗结核治疗期间发生了10例(10/24)结核瘤,硬膜内髓外结核瘤占7例(7/8),明显高于髓内结核瘤(1/6)或硬膜外结核瘤(2/10)。
■MRI在椎管内结核瘤的诊断中很重要,其特征在于T1WI上的等强度,等强度,或者T2WI上的低强度,和边缘或明显均匀增强。一些脊柱内结核瘤,尤其是硬膜内髓外结核瘤,可能与结核病治疗期间的“矛盾反应”机制有关。