椎管内神经鞘瘤的MRI诊断

目的 探讨椎管内神经鞘瘤的MRI表现特点及鉴别诊断,进一步提高对该病的认识.方法 回顾性分析荆门市第二人民医院2011年10月至2016年1月经手术病理证实的29例椎管内神经鞘瘤的MRI表现及文献复习.结果 椎管内神经鞘瘤好发于颈、腰段,胸段及骶段次之,多位于髓外硬膜下.呈圆形或类圆形结节灶,易囊变,边界清楚,T1WI呈等或稍低信号,T2WI呈等或稍高信号,囊变则T2WI呈更高信号,增强扫描肿瘤明显均匀或不均匀强化,清晰的花边样或环形强化是其特点.结论 椎管内神经鞘瘤的MRI表现具有一定的特征性,再加以对比剂的应用,多可以定性诊断,为临床治疗方案的选择提供重要依据,可成为诊断椎管内肿瘤的首选方法.

MRI diagnosis of intradural extramedullary schwannomas: a report of 29 cases

Objective To study the magnetic resonance imaging (MRI) manifestation and differential diagno-sis of intradural extramedullary schwannomas, to further improve the understanding of the disease. Methods The clini-cal data of 29 patients with intradural extramedullary schwannomas, who admitted to the Second People's Hospital of Jingmen City and confirmed by surgery pathology from October 2011 to January 2016, were retrospectively analyzed, and the current literature was reviewed. Results The intradural extramedullary schwannomas was preferentially oc-curred at neck, waist and chest section, followed by sacral section, which mostly was sited in subdural outside of pulp. The intradural extramedullary schwannomas was round or round-like focal nodules, easy to cystic change, had clear boundary. T1WI showed equal or slightly low signal, and T2WI showed equal or slightly high signal; cystic change could make T2WI showed a higher signal. After enhanced scan, the tumor showed significant uniform or non-uniform enhancing, and clear lace-like or circular enhancement was its characteristics. Conclusion MRI manifestation ofschwannoma in vertebral canal has a certain characteristic, and the application of contrast agent can provide more reli-able information for qualitative diagnosis. MRI provides an important basis for the choice of clinical treatment, which can be a preferred method for the diagnosis of intra-spinal canal tumor.