椎管神经鞘瘤的高场强MRI诊断

The High Powerful Field MRI Diagnosis of Intraspinal Neurilemmoma

【目的】探讨椎管内神经鞘瘤高场强MRI特征。【方法】回顾性分析39例经手术病理证实的神经鞘瘤MRI资料。【结果】①颈椎管11例,胸椎管15例,腰椎管13例。定位诊断准确率97.4%(38/39);定性诊断准确率94.9%(37/39)。②33例呈圆形、卵圆形或不规则形,6例呈哑铃状,全部肿瘤边缘均清楚。③35例表现为等、稍长或长T1与长T2信号,19例见明显长T1、长T2信号囊变区。增强扫描36例呈明显强化,其中19例呈周边环状、花边状或分隔状强化。④28例脊髓外硬膜下肿瘤显示杯口样改变,4例硬膜外肿瘤显示硬膜向内移位。6例跨硬膜外、下进入或通过椎间孔向外生长者显示硬膜在肿瘤处中断,相应椎间孔扩大。【结论】高场强MRI对神经鞘瘤的定位与定性诊断有重要价值。

[Objective]To study magnetic resonance imaging(MRI) characteristics of the intraspinal neurilemmoma.[Methods]The MRI findings of 39 cases with neurilemmoma confirmed by surgery and pathology in vertebral canal were analyzed retrospectively.[Results]There were 11 cases in cervical spinal canal, 15 cases in thoracic spinal canal, 13 cases in lumbar spinal canal. The accurate rate of locating diagnosis was 97.4%(38/39) and that of pathological diagnosis was 94.9%(37/39).Thirty-three tumors showed round,ovoid or irregular shape. The borders of all tumors were distinct. The signal of 35 tumors was equal, a little high or high on T1WI and high on T2WI. The cystic areas were seen in 19 tumors, which showed low signal on T1WI but high signal on T2WI. Thirty-six tumors demonstrated obvious enhancement by enhanced scanning,19 cases of them manifested annular enhancement.Tweenty-eight cases were found to locate in extramedullary subdural space manifesting the shape of cup. The dura maters of 4 tumors locating in epidural space showed inward displacement.The locations of 6 tumors from subdural to epidural and at intervertebral foramen demonstrated the shape of dumb bell , intervertebral foramen amplificated and the dura mater was blocked by the tumors. [Conclusion] The high powerful field MRI plays an important role in the diagnosis of neurilemmoma in position and character.