脊髓马尾区神经鞘瘤的MRI诊断分析

Diagnostic analysis of MRI with neurilemoma of cauda equina

目的:探讨马尾神经鞘瘤的MRI诊断价值。方法:回顾性分析18例经手术病理证实的马尾神经鞘瘤的MRI平扫和增强后的形态及信号特点,以及受累马尾神经的形态及信号特点。结果:18例马尾神经鞘瘤中16例为单发,2例为多发(共5个病灶),肿瘤长径平均30mm。14例位于硬膜内,肿瘤为圆形、卵圆形,相邻脊髓圆锥受压或马尾神经推压移位;3例跨硬膜内外生长,肿瘤为哑铃形,沿椎间孔向外生长,椎间孔扩大,椎体后缘压迫性骨吸收。1例位于硬膜外,肿瘤呈哑铃状,自椎管沿椎间孔向外延伸,相邻蛛网膜下腔受压变窄。病灶T1WI等或(和)低信号,T2WI等或(和)高信号,2例T2WI混杂斑点状低信号,13例内部见囊变区,增强扫描肿瘤呈明显均匀或不均匀强化,13例可见肿瘤上、下方或侧方有增粗强化的马尾神经。结论:MRI能清楚显示马尾神经鞘瘤的大小、形态、内部情况及与邻近马尾神经、硬膜囊的关系,对于临床诊断及制定手术方案具有非常重要的意义。

Objective： To evaluate the diagnostic significance of magnetic resonance imaging （MRI） for neurilemoma of cauda equina. Methods：Eighteen cases with neurilemoma of cauda equine which were confmned by surgery and pathology, and plain and intensified scannings of MPd were performed, the signal intensity and enhanced status of tumors as well as the characteristics in shape and signal of cauda equina were analyzed retrospectively.Results： 18 cases of neurilemoma in 16 cases for single, two cases were multiple （a total of five lesions）, tumor length of the average 30 mm. The locations of 14 cases were intradural, the tumors showed round, oval, spinal cord was compressed or cauda eqnina was pushed; and three cases were transdural like a dumbbell, along the outside intervertebral foramen growth, expansion of intervertebral foramen, after the margin of vertebral compression bone resorption. One was extradural in one case of epidural, a dumbbell-shaped tumor, since the canal along the intervertebral foramen outward extension of the adjacent subarachnoid space narrows. T1WI, such as lesions or （and） low signal, T2WI, and so on, or （and） high signal, two cases of low-dot T2WI mixed signals, 13 cases of internal cystic areas, enhance the tumor scans showed homogeneous or heterogeneous enhancement, 13 cases that tumors, the bottom or side to strengthen a thickening of the cauda equina. Conclusion： MRI can clearly show that the tumor of cauda equine of size, shape, internal and with cauda equine of neighbours, the relationship between the dural sac, for clinical diagnosis and development of surgery programme has very important significance.