颅底粘液瘤与脊索瘤的临床及神经影像学和组织学对比分析

目的研究颅底粘液瘤和脊索瘤的临床表现及神经影像学和组织学之间的关系。方法对７例粘液瘤和１３例脊索瘤行神经影像学和组织学检查。结果（１）临床表现：粘液瘤以动眼神经损害及眼球突出为主,脊索瘤多表现为后组颅神经的损害。（２）头颅Ｘ线平片：粘液瘤组为病变局部有不规则点状钙化和骨质破坏,脊索瘤组可见斜坡骨质破坏,钙化呈菜花状。（３）ＣＴ及ＭＲＩ：可以清晰的显示粘液瘤和脊索瘤发生部位,侵犯方向及肿瘤与周围结构的解剖关系。（４）病理特点：粘液瘤为细胞呈星芒状排列,脊索瘤的特征为细胞呈囊泡状。结论颅底粘液瘤与脊索瘤的临床表现、神经影像学及组织学的对比分析,对临床鉴别诊断有重要意义,特别是对指导手术方式及入路更具有实用价值。

Clinical study on myxoma and chordoma in the skull base

Objective The clinical manifestation, neuroimaging properties, and pathologic changes of myxoma and chordoma were studied. Methods Their neuroimaging properties and pathologic changes of myxoma 7 cases and chordoma 13 cases were analyzed. Results (1) Clinical manifestation: the injury of oculomotor nerve and exorbitism is dominant in myxoma, but the injury of posterior cranial nerves is dominant in chordomas. (2) Plain skull X ray film: local irregular punctate calcification and osseous necrosis were common in myxoma. Clivus invasion moruloid calcification and cauliflower like calcification are always seen in chordoma. (3) CT and MRI: Location of the tumor and their relations with the adjacent structure were clear. (4) Pathologic changes: Cells are punctately arranged in myxoma, and vesicularly arranged in chordoma.Conclusion The clinical study of myxoma and chordoma is not only useful for their differiental diagnosis, but can provide valuable clues for their surgical approach as well.