脊索瘤MRI表现与鉴别

目的:分析脊索瘤的MRI表现及与其他疾病的鉴别,探讨MRI的诊断价值。材料和方法:搜集16例经手术病理证实的脊索瘤,分析其MRI表现及有关鉴别诊断。其中13例行头颅MR平扫和增强扫描,3例分别行颈椎、骶尾部平扫。结果:13例颅底脊索瘤,局限于斜坡者4例,累及鞍区、中颅凹、蝶窦,呈广泛浸润生长者8例,同时累及后颅凹者1例;T1WI呈不均匀等低信号块影,T2WI呈不均匀高信号,10例增强扫描病灶呈不均匀强化;骶尾部脊索瘤2例,颈椎脊索瘤1例,在T1WI和T2WI上均呈混杂信号块影,可见骨质破坏,上段颈髓受累。16例均行手术治疗,有12例术后定期复查均有病变复发征象。结论:MRI可明确显示肿瘤的生长方式、浸润范围及与邻近结构的解剖关系,对诊断和手术治疗的评估有重要参考价值。

MRI features and differentiation of chordomas

Objective: To study MRI features and its value in diagnosis and differential diagnosis of chordomas. Materials and Methods: Sixteen patients with surgical and pathologic proved chordomas were analyzed. Regular MRI and enhanced MRI of brain were obtained in 13 of 16 cases, MRI of cervical vertebra or sacrococcyx were obtained in 3 of 16 cases. Results: Chordomas at cranial base were seen in 13 patients, at sacrococcyx were seen in 2 patients, at cervical vertebra were seen in 1 patient. Of the 13 patients with chordomas at cranial base, 4 patients had lesions only at clivus. Sella, middle cranial fossa and sinus sphenoidalis with wide spread infiltration were seen in 8 patients. And with posterior cranial fossa involved at the same time was seen in 1 patient. Sixteen patients were treated surgically, 12 of the 16 cases had recurrence. Conclusion: MRI can demonstrate the fashion of growth, range of involvement and its anatomic relation with adjacent structures in patients with chordomas. It has important value in diagnosis and evaluations for operation.