椎管内占位病变的高场强MRI诊断与鉴别诊断

目的 探讨高场强MR对椎管内占位病变的诊断与鉴别诊断价值。方法 回顾性分析53例经手术病理证实的椎管内占位病变的MRI资料．肿瘤位于颈椎管18例，胸椎管23例，腰椎管12例。病理上属神经鞘瘤17例，脊膜瘤8例，神经纤维瘤4例，转移瘤9例，星形细胞瘤3例，室管膜瘤2例，蛛网膜囊肿3例，淋巴瘤1例，脊索瘤2例，海绵血管瘤2例，血肿1例，畸胎瘤1例。结果 MRI检查结果：①肿瘤部位：脊髓内肿瘤5例，脊髓外硬膜内肿瘤20例，硬膜外腔肿瘤24例，4例硬膜外与硬膜下均受累且通过椎间孔到达椎旁；MRI诊断符合率92．45％；②不同肿瘤在发病部位、肿瘤MRI信号、强化特征、硬膜信号与形态、脊髓形态与蛛网膜下腔改变以及脊椎骨质等都有各自特点。结论 高场强MRI在椎管内占位病变的诊断中与鉴别诊断有重要价值。

High powerful field MRI diagnosis and differential diagnosis of intraspinal lumps

Objective To study the value of magnetic resonance imaging (MRI) in diagnosing and differentially diagnosing intraspinal tumors. Methods The MRI findings of 53 cases with intraspinal tumors confirmed by surgery and pathology were analyzed retrospectively.18 cases located in cervical spinal canal,23 in thoracic spinal canal,12 cases in lumbar spinal canal or sacral vertbra. As for the disease entity,17 cases were of neurilemmoma, 8 cases of spinal meningioma,4 cases of fibroneuroma,9 cases of metastased tumor,3 cases of astrocytoma and arachnoid cyst respectively,2 cases of ependymoma,chordoma and angiocavermoma respectively,one case of lymphoma,hematoma and teratoma respectively. Results Of 53 cases,24 were located by MRI in the epidural space and 20 in the subdural space, while 5 in the myelo-parenchyma,4 case tumors were involved in both subdural space and epidural space and went through intervertebral foramen to vertebral edge.The accuracy of diagnosis by MRI was 92.45%.Intraspinal tumors had their characteristic manifestations of the onset, tumor signal, enhancement, the morphology of dura mater, spinal cord and subarachnoid space and vertebra. Conclusion The high powerful field MRI plays an important role in diagnosing and differentially diagnosing intraspinal tumors.