颅底脊索瘤的MRI表现及其对临床手术的指导意义

MRI Features and the Guiding Value for Operation of Cranial Base Chordoma.

目的探讨颅底脊索瘤的MRI表现及其临床手术的指导意义。方法收集本院及中山大学附属第三医院近5年15例经手术和病理证实的颅底脊索瘤的MRI影像学表现进行了回顾性分析。结果颅底脊索瘤发生于颅底中线处的斜坡和(或)鞍区,并广泛侵犯大血管等重要结构;在T_1WI主要表现为低信号,T_2WI表现为不均匀高信号,Gd-DTPA静脉注射增强后,均有较明显的不均匀强化。结论 MRI检查颅内脊索瘤的临床意义在于明确肿瘤的部位、大小和范围,评价肿瘤的生长方式和对大血管等重要结构的侵犯情况,从而制定合适的手术方案。

Objective To explore the guiding value for operation of MRI in diagnosing the cranial base chordoma. Methods MRI features of 15 cases with cranial base chordoma, which were proved by biopsy and surgery, were retrospectively analyzed. Results Most of the cranial base cbordoma were located in the middle area of the skull base such as clivus and sellar region and always invaded extensively the nerves and major intracranial vessels of skull base. All tumors were hypointense on T2WI and enhanced more markedly, but steady heterogeneous. Conclusion MRI examination is of great clinical signifiance in delineating the location, size and extension of cranial base chordoma,and showed anatomic relation with surrounding structures such as the major intracranial vessels of skull base, which is very important in surgical planning.