颅底脊索瘤的CT、MRI分析

Analysis of CT and MRI features in chordoma of the skull base

目的:分析颅底脊索瘤的CT、MRI表现,探讨CT和MRI的诊断价值。方法:回顾性分析经手术病理证实的15例颅底脊索瘤,6例同时进行CT、MRI扫描,4例仅行CT扫描,5例仅行MRI扫描,2例同时行CTA检查。结果:颅底脊索瘤发生在斜坡8例,鞍区5例,颈静脉孔区1例,1例同时跨颅中、后窝生长。形态多为类圆形或不规则形,13例边界清晰,2例边界不清晰。CT表现肿块呈不均匀等或稍高密度软组织块,7例见斑点状钙化,8例见不同程度骨质破坏。MRI肿块信号不均匀,T1WI呈稍低信号或等信号,T2WI呈明显高信号,增强扫描呈不均匀轻中度强化。MRI扫描对病变范围的显示优于CT。结论:颅底脊索瘤有典型的好发部位,T2WI明显高信号较具特征性,CT和MRI对术前诊断颅底脊索瘤有较大价值。

Objective：To analyse the CT and MRI features in chordoma of the skull base,evaluate the value of diagnosis with CT and MRI in base cranial chordoma.Methods：CT and MRI features in 15 patients with pathologically-proved basicranial chordoma were retrospectively analyzed.Both CT and MRI scanning were performed in 6 patients,while only CT scanning was performed in 4 patients and only MRI scanning in 5 patients and 2 cases were evaluated with CTA.Results：Of 15 cases,the tumors located in clivus in 8,in the sella turcica in 5,in the jugular foramen in 1,in the middle and posterior cranial fossa simultaneously in 1.The most shape of them were oval or irregular.13 tumors had well-defined margin and 2 with ill-defined margin.The lesions were inhomogeneous iso-or slight hyper-intense on CT with calcification in 7 cases and bone destruction in 8 cases.The tumors showed inhomogeneous signal intensity with iso-,and hypo-signal intensity on T1WI and extremely high signal intensity on T2WI.Inhomogeneous slight to moderate enhancement revealed in all patient.MR imaging is more advantage than CT in displaying borderline of tumor.Conclusion：Basicranial chordomas are often originated from somewhere typically.The extremely high T2WI signal intensity is the characteristic of MRI finding in chordoma.CT and MRI play an important role in preoperative diagnosis of basicranial chordomas.