骶部硬膜外囊肿的临床影像学表现与病理分析(18例报告及文献综述)

目的探讨骶部硬膜外囊肿的临床影像学与病理特点。方法本组18例均行腰骶部及骨盆X线平片检查,其中17例行CT扫描、11例行MRI检查、7例行脊髓造影、4例行脊髓造影CT(CTM)扫描,结合文献分析其影像学表现。结果本病临床误诊率为78%,X线诊断率17%,CT诊断率72%,MRI检查、脊髓造影、CTM扫描诊断率100%。18例均手术切除,病理报告为硬膜外囊肿,椎管内型13例、椎管外型3例及混合型2例。随访15~32个月,平均24个月,未发现症状加重和复发病例。结论骶部硬膜外囊肿为椎管内或椎管外通过颈口与蛛网膜下腔相通的硬膜外囊性肿物,临床和影像学具有特征性表现。

Manifestation of Clinical Imageology and Pathological Characters of the Sacral Epidural Cyst: A Report of 18 Cases with Literature Review

Objective To study the clinical diagnosis level,the clinic-imaging and pathological characteristics of sacral epidural cyst.Methods 18 cases of sacral epidural cyst underwent radiography,of them,CT scan in 17,MRI in 11,myelography in 7 and CT myelography(CTM) in 4 were performed.Imaging findings were analysed with literature reriew.Results The rate of the misdiagnosis was 78% in clinic,while the diagnostic rates were 17% at radiography,72% at CT,100% at MRI,myelography and CTM.All cysts were excised by surgery in all cases and proved by pathology,including intra-spinal canal in 13,extra-spinal canal in 3 and mixed in 2.Follow-up for 15-32 months,none was recurred.Conclusion Sacral epidural cysts are the cystic masses which are communicated with subarachnoid space through the neck open,and these cysts are of clinic-imaging characteristics.