29例脊索瘤的影像学诊断及鉴别诊断

目的探讨脊索瘤的影像学表现及鉴别诊断。方法回顾性分析经手术病理证实的29例脊索瘤的影像学表现及特点。结果29例脊索瘤中，发生于骶尾部15例（51．7％），发生于颅底13例（44．8％），发生于外周1例（3．5％）。平片可见颅底及骶尾椎融骨性骨质破坏；CT可特征性显示斜坡及骶尾椎膨胀性软组织肿块及广泛融骨性骨质破坏；MRI对病变范围的显示优于CT。结论CT对显示脊索瘤的骨质破坏、残存方面优于MRI，但MRI对脊索瘤的范围、内部结构及周围神经、血管的关系具有较高的敏感性和一定的特征性，有助于确定外科手术方案及对术后的评估。

Imaging Diagnosis and Differential Diagnosis of Chordomas

Objective To investigate the imaging manifestations and differential dignosis of chordoma. Methods The imaging manifestation and characteristic of chordoma in 29 cases proved by surgery and pathology were analyzed retrospectively. Results In this series of 29 chordoms, the lesions located at the region of sacrococcygeal region 15 cases （ 51.7% ）, at the skull base in 13 cases （ 44.8% ） and 1 case （ 3.5% ） outside the axial skeleton as an extra-axial chordoma or parachordom. Bone destruction in the areas near skull base and saerococcygeal region could be found on radiography ; On CT, chordom typically appeared as a expansile soft-tissue mass that arises from the clivus and sacrococcygeal region with associated extensive lyric bone destruction; MR imaging was considerably superior to CT in the delineation of lesion extent. Conclusion CT shows bone invasion easier than MRI, but MRI can well display the extent, interior structure of tumors, as well as its relationship with adjacent nerves andvessel, and therefore benefits the decision of surgical project and the postoperative evaluation.