MSCT的MPR技术在脊柱旁神经鞘瘤的诊断价值

The Value of Multi-slice Spiral CT MPR Technology in Diagnosis of Neurilemmoma Beside the Spine

目的探讨多层螺旋CT(multi-slice spiral CT,MSCT)的多平面重建技术(multi-planar reconstruction,MPR)在脊柱旁神经鞘瘤的诊断与鉴别诊断的临床价值。方法回顾性分析22例脊柱旁神经鞘瘤的临床、影像资料,对比各例的多层螺旋CT横轴位及其MPR表现。结果 22例中15例位于胸段脊柱旁,7例位于腰段脊柱旁;8例跨越椎管内、外,伴相应椎间孔扩大;14例位于椎管外、脊柱旁。CT平扫显示5例较小肿块的密度大致均匀,增强扫描较均匀强化;17例较大肿块的密度不均匀,内有囊状更低密度灶;5例有斑点钙化影,增强扫描均呈不均匀强化。单纯CT横轴位图像对8例跨越椎管内、外的肿瘤定位准确,其余14例椎管外的肿瘤定位较困难,易与周围病变混淆。MPR明确显示肿块与神经根相连、受压及周围结构的关系,22例肿瘤全部定位正确。结论多层螺旋CT的MPR技术对椎管外神经鞘瘤的定位有独特优势,结合肿瘤的密度特点,对脊柱旁神经鞘瘤的诊断及鉴别诊断有重要意义。

Objective To evaluate the clincal value of multi-planar reconstruction （MPR） and multi- slice spiral CT（MSCT） in diagnosis and differential diagnosis of neurilemmoma beside the spine. Methods The clinical and imaging datas in 22 cases of neurilemmoma were analyzed, axial MSCT and MPR images were compared. Results 22 cases in thoracic spine section 15 cases, 7 cases of vertebral located near, 8 cases of inside and outside, spanning vertebra with corresponding between vertebra hole expansion, 14 cases in the spine vertebra, beside. CT fiat display 5 cases and small mass density roughly uniform, enhance the scanning evener aggrandizement, 17 cases of large mass density, uneven cystic lower density stove, 5 cases of calcification spots, there are scanning. Simply CT images to a 8 distrbution across vertebra inside and outside of the tumor accurate positioning and the rest of the spinal canal 14 cases of tumor location is difficult, easy and surrounding lesions confusion. MPR clearly show with nerve root and mass pressure and surrounding structures, and all the correct orientation tumor. Conclusion MPR technology with MSCT has distinct ascendancy in the localization, combined with density characteristics of tumors, it has important significance in diagnosis and differential diagno- sis of neurilemmoma beside spine.