少见和不典型椎管肿瘤的MRI诊断和误诊分析

目的：探讨少见和不典型椎管肿瘤MRI误诊原因,提高对该类疾病的认识。资料与方法：对16例少见和不典型椎管肿瘤进行回顾性手术病理对照分析。结果：8例实性神经鞘瘤,7例MRI误诊为脊膜瘤,1例误诊为室管膜瘤;2例神经母细胞瘤误诊为硬膜外淋巴瘤和脊膜瘤;2例海绵状血管瘤误诊为神经鞘瘤;3例血管畸形误诊为室管膜瘤、神经鞘瘤和硬膜外脓肿：1例血管球瘤误诊为硬膜外淋巴瘤。结论：在评价椎管肿瘤方面,MRI具有绝对优势,根据肿瘤的位置、信号强度和均匀度,再辅以对比剂的恰当应用,不仅对典型的肿瘤能做出正确诊断,对不典型的和少见的椎管肿瘤也可提供更多可靠的信息。

Analysis of MRI Mistakes in Diagnosing Rare and Atypical Spinal Canal Tumors

Objective To discuss the causes of MRI mistakes in diagnosing rare and atypical spinal canal tumors, to make a further understanding of these tumors.Materials and Methods Both MRI and pathological findings in 16 cases with rare or atypical spinal canal tumors were retrospectively analyzed. Results Of 16 cases, 8 were solid neurinomas, of which 7 were misdiagnosed as spinal meningioma and one as ependymoma. Two neuroblastomas were misdiagnosed as epidural lymphoma or spinal meningioma. Two cavernous hemangiomas were wrongly diagnosed as neurinoma. Three vascular malformations were mistaken for ependymoma, neurinoma or epidural abscess. One glomus tumor was misinterpreted as epidural lymphoma.Conclusion MRI has absolute superiority in displaying spinal canal tumors. Based on the location, signal intensity and homogeneity of the tumor, with the help of contrast enhancement, MRI can not only make a correct diagnose for typical spinal canal tumors, but also provide more reliable information for the rare and atypical spinal canal tumors.