椎管内非典型神经鞘瘤和非典型脊膜瘤的MRI鉴别诊断

目的:分析椎管内非典型神经鞘瘤（intraspinal atypical schwannoma,IAS）和非典型脊膜瘤（atypical spinal meningioma,ASM）的MRI征象和临床特点，讨论两者的MRI鉴别诊断。方法:回顾性分析80例我院2017年01月至2020年07月经病理证实的IAS和ASM的术前MRI图像，提取其影像特征，运用SPSS分析软件对它们的MRI特征及临床特点进行统计分析。结果:IAS组平均年龄(51.5±10.1)岁，ASM组平均年龄(61.1±12.9)岁；两组在性别、年龄及发病部位上具有非常显著的统计学差异（P均＜0.01）。在形态学上IAS组和ASM组的纵径、横径及纵横径比之间的差异均无统计学意义（P均＞0.05）。在MRI信号特点（T1WI、T2WI信号强度、T2WI信号混杂性、是否囊变）及强化特征（强化程度、强化均匀性、是否环形强化）方面两组之间的差异均具有非常显著的统计学意义（P均＜0.01）。结论:区分IAS和ASM的MRI征象和临床特点，对其鉴别具有参考价值。

MRI differential diagnosis of intraspinal atypical schwannoma and atypical spinal meningioma

Objective:To analyze the MRI characteristics and clinic features of the atypical intraspinal schwannoma and meningioma,and discuss the MRI differential diagnosis key point.Methods:The preoperative MRI of 80 cases of intravertebral schwannoma and meningioma confirmed by pathology from January 2017 to July 2020 in our hospital were analyzed retrospectively.The imaging features were extracted,and the MRI features and clinical features were statistically analyzed using SPSS.Results:The mean age of the intraspinal atypical schwannoma（IAS) group and the atypical spinal meningioma(ASM) group was (51.5±10.1) years old and (61.1±12.9) years old.There were significantly statistical differences between the two groups in gender,age and location of the disease（P＜0.01).Morphologically,there was no statistical significant differences in longitudinal diameter,transverse diameter and aspect diameter ratio between these two groups（P＞0.05).In MRI signal characteristics（T1WI,T2WI signal intensity,T2WI signal hybridization,cystic change) and enhancement characteristics（degree of enhancement,uniformity of enhancement,ring-like enhancement),the statistical differences between these two groups were significant（P＜0.01).Conclusion:The MRI and clinical features of intraspinal atypical schwannoma and atypical spinal meningioma are valuable for the differential diagnosis.