腰椎管肿瘤的误诊分析

目的分析腰椎管肿瘤误诊为腰椎间盘突出症的原因，减少误诊发生。方法对1997年2月-2007年11月我们收治误诊为腰椎间盘突出症的腰椎管肿瘤的20例进行回顾分析，分析二者之间的症状、体征和影像学资料等。结果本组患者全部误诊，误诊时间为0．5～10年，平均6．5年。20例均曾行CT检查，3例曾行MRI检查，均报告为腰椎间盘突出症，并按椎间盘突出症治疗，效果不佳，而后经仔细询问病史，全面体格检查，针对怀疑部位行MRI检查，诊断为腰椎管肿瘤，并经手术及病理检查证实。结论腰椎管肿瘤易误诊为腰椎间盘突出症，病史询问不仔细，查体不全面，过分依赖影像检查，对某些体征以及影像检查征像认识不清等是引起误诊的原因。

Misdiagonisis analysis of tumor in iubar Vertbral canal

Objective To reduce misdiagonisis rate through analysis the reason of tumor in vertbral canal diagnosing to lu-bar inervertebral disc protrusion (LIDP). Methods A total of 29 misdiagonised patients were enrolled from Febrary, 1997 to Novermber, 2007,each were retrospectively analyzed of symptoms, physical sign, imaging information. Results All cases were misdiagoniscd from 6 months to 10 years, with a mean time of 6.5 years,all of 20 patients received CT,and 3 received MRI,which were diagnosed to LIDP and assigned treatment,but having no good effect,and the final diagnosis to tumor in vertbral canal through inquiring patient history, complete physical examination (CPX), mading MRI for suspected locus, and verified by operation and patho-scopy. Conclusion The main reason of misdiagonising was uncarefurely inquiring patient history, discomplete CPX, exces-sively depdending on imaging-scopy,unclear recognition with cetyltrimethylammonium bromide(CTAB) and imaging-scopy signe.