椎管内神经鞘瘤的MRI诊断

目的 探讨椎管内神经鞘瘤的MRI诊断。方法 收集手术病理证实的椎管内神经鞘瘤42例，分析其MRI表现特点。结果 42例中，39例位于髓外硬膜下，3例硬膜外及硬膜下间隙均被累及。肿瘤于平扫T1WI多表现为稍低信号，T2WI为高信号。如果肿瘤有坏死、液化或囊变，则肿瘤信号不均匀。肿瘤边界清楚，形态规则。硬膜内外均累及者呈哑铃型。增强扫描20例为均匀性强化，17例为不均匀性强化，5例为环形强化。40例可见脊髓受压、推移。31例见肿瘤侧蛛网膜下腔增宽、对侧蛛网膜下腔变窄。结论 准确定位及分析MRI表现是椎管内神经鞘瘤诊断的关键。

MRI diagnosis of intraspinal neurinoma

Objective To explore the MRI diagnosis of intraspinal neurinoma. Methods MRI findings of 42 cases of intraspinal neurinoma confirmed pathologically were analyzed. Results Of the 42 cases, intraspinal neurinoma was found to be located in extramedullary subdural space in 39 cases, 3 cases in both subdural and epidural spaces. Multiple lesion was found in 3 cases. Most cases showed slightly low signal intensity on T1WI and high signal intensity on T2WI. Heterogeneous signal intensity was found if there were tumor necrosis, liquefaction and cystic changes. All tumors were well defined. Enhanced scanning demonstrated 20 cases of homogeneous enhancement, 17 of heterogeneous enhancement, 5 of rim like enhancement. Compressed and displaced spinal cord was found in 40 cases. Broadened subarachnoid space on the lesion side and narrowed subarachnoid space on the contralateral side were found in 31 cases. Conclusion Precise localization of intraspinal neurinoma and careful analysis of MRI features are the key step for the diagnosis of intraspinal neurinoma.