脊髓髓内肿瘤的鉴别诊断与手术时机

目的探讨各种脊髓髓内肿瘤的临床和影像学的鉴别诊断,选择合理的手术时机。方法以运动功能障碍分级,对经显微外科手术及病理证实的１４７例（１６０个肿瘤）髓内肿瘤进行统计学分析,并比较它们的影像学表现。结果主要的脊髓髓内肿瘤的临床表现无明显不同,而其影像学上各有其特点。无运动功能障碍组的肿瘤明显小于发生运动功能障碍组。手术前、后运动功能障碍的分级呈线性正相关。结论磁共振影像（特别是对比剂强化后的）能对大多数室管膜瘤、星形细胞瘤和血管网状细胞瘤加以鉴别。及时地微创性的显微手术切除肿瘤,可以获得满意疗效

Differential diagnosis and operative timing of intramedullary spinal cord tumors

Objective To discuss the differential diagnosis of various kinds of intramedullary spinal cord tumors, and choose the right operative timing. Methods On grading the dysfunction of the movement, an analysis has been made statistically for 147 cases with 160 tumors resected by microneurosurgery and confirmed pathologically. Their neuroimage have been also compared. Results The clinical manifestations of main kinds of intramedullary spinal cord tumors are not significantly different, but there are certain characteristic features in their neuroimage. The tumors of grade 0 group (normal movement) are obviously smaller than those of other grades groups. The pre and post operative grades of motor disturbance show a better, positive linear correlation. Conclusions MRI, particularly its enhancement, can differentiate an ependymoma from astrocytoma and hemangioblastoma in most cases. A satisfactory result can be achieved to resect the tumor immediately by using the minimally invasive, microsurgical techniques.