目的 分析胸部髓外造血(TEMH) 与髓脂肪瘤(ML)的MSCT与MRI影像特征。 方法 回顾性分自2010年1月-2017年7月在 我院经病理结果明确的10例TEMH及4例ML 患者的影像资料，明确胸部髓外造血与髓 脂肪瘤的MSCT与MRI影像特征。结果 MSCT 及MRI均能明确显示病灶，可见后纵膈髓 外造血组织瘤样增生的肿块及髓脂肪瘤， 14例患者共计18个后纵膈瘤样增生和4个 髓样脂肪瘤，影像资料均可见后纵膈脊柱 旁软组织肿块影，且肿块与脊柱宽基底 相连，自T2-T12椎体检出42个病变，10 例TEMH为后纵膈多发肿块，4例ML患者分 别为单发孤立软组织肿块2例、双侧对称 性肿块2例；4例TEMH行MSCT可见均匀等 密度，强化程度为中度，MRI可见T1WI、 T2WI等信号，增强扫描强化均匀，为多发 灶，且位于椎旁；6例TEMM为不均匀等低 混合密度，增强扫描可见部分软组织轻度 强化，MRI检查T1WI、T2WI均呈等低密度 混合信号，强化不均匀，椎旁可见多个病 灶；4例髓脂肪瘤患者均为不均匀等低混 合密度，强化不均匀，T1WI扫描可见软组 织低信号，脂肪组织则为中高信号，T2WI 扫描脂肪组织未见强化，仅可见软组织 强化。结论 MSCT及MRI影像资料或能为 TEMH、ML的临床诊断及鉴别提供一定影像 学依据，值得临床借鉴。

Objective To analyze MSCT and MRI findings of thoracic extramedullary hematopoiesis (TEMH) and myelolipoma (ML). Methods Imaging data of 10 cases with TEMH and 4 cases with ML diagnosed by pathology in the hospital from January 2010 to July 2017 were retrospectively analyzed. MSCT and MRI findings of TEMH and ML were identified. Results Both of MSCT and MRI could clearly display lesions. There were mediastinal extramedullary hematopoiesis tissue tumor-like hyperplasia and ML. In 14 cases, there were 18 posterior mediastinal tumor-like hyperplasia and 4 myeloid myelolipomas. The imaging data showed soft tissue masses beside the posterior mediastinal spine, and masses were connected with the spinal wide base. 42 lesion of T2~T12 vertebral bodies were detected. 10 cases of TEMH were posterior mediastinal multiple masses, while 4 cases of ML included 2 cases of single solitary soft tissue mass and 2 cases of bilateral symmetrical masses. MSCT of 4 cases of TEMH showed homogeneous and equal density and moderate enhancement. MRI showed equal signal on T1WI and T2WI and enhanced scan showed homogeneous enhancement, multiple foci located in the paraspinal region. 6 cases of TEMM showed inhomogeneous and equal-low mixed density. Enhanced scan showed partial soft tissue slightly enhanced. MRI showed equal-low mixed density on T1WI and T2WI, with inhomogeneous enhancement and multiple lesions in the paraspinal region. 4 cases of ML showed inhomogeneous and equal- low density, with inhomogeneous enhancement. T1WI scan showed soft tissue low signal while adipose tissue showed medium high signal. T2WI scan showed no enhancement in adipose tissue, and there only was soft tissue enhancement. Conclusion MSCT and MRI data can provide imaging basis for the clinical diagnosis and identification of TEMH and ML.