椎管内脊膜瘤和神经鞘瘤MRI鉴别

目的分析椎管内脊膜瘤和神经鞘瘤的MRI特点,以得出两者重要鉴别意义的影像学表现。方法回顾性分析29例椎管内脊膜瘤和神经鞘瘤的MRI影像学特征。结果①脊膜瘤组的纵径和横径具有显著差异(P<0.01),且纵径大于横径;神经鞘瘤组的纵径和横径无明显统计学差异(P>0.05);②以下8个因素在脊膜瘤和神经鞘瘤之间的差异具有非常显著的意义(P<0.01),分别是:肿瘤形态、邻近椎间孔扩大、肿瘤与硬膜面夹角、脊膜尾征、肿瘤内部坏死、囊变、T1WI信号强度、T2WI信号强度及T2WI信号混杂性;③性别、发病部位、环状强化因素在脊膜瘤和神经鞘瘤之间的差异具有显著意义(P<0.05)。结论 MRI对椎管内脊膜瘤和神经鞘瘤的鉴别有重要价值。

The difference between spinal meningiomas and schwannoma on MRI appearance

Objective To analyze MRI features of spinal meningioma and schwannoma in order to acquire helpful imaging features for differential diagnosis. Methods The MRI appearances of 29 cases with spinal meningiomas and schwannomas verified by surgery and pathology were retrospectively analyzed. Results （1） The longitudinal diameter compared with the transverse diameter in the group of spinal meningiomas showed extremely significant difference （ P 〈0.01）, and the long diameter was longer than diameter transversa. The longitudinal diameter compared with diameter transversa in the group of schwannomas had no significant difference （ P 〉0.05）; （2） Eight factors as follows between spinal meningiomas and schwannomas showed extremely significant difference （ P 〈0.01） ： the shape of the tumor, expansion of the neighboring foramen intervertebrale, the angle to spinal dura mater, ＂dural tail sign＂, cystic degeneration or necrosis in tumor, the signal of T1 WI, the signal of T2WI, the miscellaneous signal on T2 WI; （3） Three factors as follows between spinal menin- giomas and schwannomas showed significant difference （ P 〈0.05）： sex, location, ring-like enhansement. Conclusion MRI in the differential diagnosis of spinal meningiomas and schwannomas has an important value.