髓外硬膜下肿瘤的低场MRI诊断(附36例分析)

目的 探讨低场MRI对椎管内髓外硬膜下肿瘤的定性诊断。方法 36例,男性18例,女性18例,平均年龄43.3岁。临床表现为肢体无力、活动障碍、大小便失禁等。结果 神经纤维瘤的MRI特点为形态为哑铃形、类圆形多见,信号多呈长T1或稍长T1,长T2信号,增强扫描呈不均匀强化;神经鞘瘤、长椭圆形,位于脊髓背侧或背外侧,信号为均匀长T1长T2信号,增强扫描呈环形强化或均匀强化。脊髓瘤则多呈类圆形,贴敷硬脊膜,呈特征性等T1等T2信号,增强扫描呈均匀强化。神经纤维肉瘤及神经鞘肉瘤具有神经纤维瘤及神经鞘瘤特点的同时伴有周围结构侵犯。单纯性囊肿表现为均匀长T1长T2信号,增强扫描不强化。转移瘤则需结合病史才得以诊断。结论 椎管内硬膜下肿瘤各自具有一定的MRI特征,有利于提高对其定性诊断。

Diagnosis of intradural extramedullary tumors by low field MRI (analysis of 36 cases)

Purpose To investigate the qualitative diagnosis to intradural extramedullary tumors by low field MRI. Methods 36 cases included 18 males and 18 femals ,average age 43.3 years .Clinical situation were limbs powerless ,activity obstacle ,urinary and fecal incontinence, and so on. Results Neurinomas were displayed as dumbbell or roundish in shape, low signal (or slightly low signal)on T1WI and high signal on T2WI, enhanced inhomogeneously. Neurilemmome apearted on ellipsoidal, located the back of the spinal cord, homogeneously low signal on T1WI and high signal on T2WI, ring - like or homogeneous enhancement. Meningiomas had broad dural base, homogeneously and equal signal on T1WI or T2WI, enhanced homogeneously. Neurofibrosarcoma and neurilemmosarcoma had the features of neurinoma and neurofibroma, but they invaded the tissues around the tumors. Simple cyst was homogeneously low signal on T1WI and high signal on T2WI, not enhanced. Metastatic tumor was diagnosised according to the primary tumor. Conclusion Each kind of intradural extramedullaries tumors has his features of MRI. MRI is helpful to qualitative diagnosis of tese thumors.