颅底及骶骨脊索瘤的CT与MRI诊断价值

Diagnosis value of CT and MRI in chordoma of cranial base and sacrum

目的:评价CT和MRI对脊索瘤的诊断价值。方法:回顾性分析28例经手术和病理证实的脊索瘤患者的CT与MRI表现。结果:28例脊索瘤病例中发生于颅内17例,其中,斜坡型9例,蝶鞍型3例,颅中窝型3例,鼻咽型2例;骶骨11例:其中,发生骶2水平以下6例,骶3水平以下3例,骶4水平2例;均行CT与MRI扫描,显示软组织肿块,骨质破坏、囊变、坏死及钙化,病变可侵犯周围软组织。结论:CT对显示骨质破坏、残存骨质方面优于MRI,但MRI伪影少,并可清晰显示病变的部位、大小、范围、内部结构及与周围神经血管的关系等,有助于外科手术及术后评估,所以两者结合对大多数病例术前即可作出进一步诊断。

Objective：To evaluate the diagnosis value of CT and MRI in chordoma of cranial base and sacrum.Methods：28 cases chordoma who were confirmed by operation and pathology were performed by CT and MRI,to review the CT and MRI imaging appearence of them.Results：Among 28 cases chordoma,tumors located in intracalvarum in 17 patients： 9 cases of tumors located in clivus,3 cases of in cella turcica,3 cases of in the middle cranial fossa,2 cases of in nasopharynx.Tumors located in sacrum in 11 patients： tumors located below the second sacrum in 6 patients,below the third sarum in 3 patients,below the forth sarum in 2 patients.The CT and MRI manisfestation of all the tumors showed soft tissue mass,destruction of bone,necrosis,cystolization and calcification.The tumor could invade peripheral tissue.Conclusion：CT is superior to MRI in showing the destruction of bone and the relic bone,but the image artifacts is less with MRI than CT,and the location,size,extension,inner structure of the tumor and the connection with peripheral nervous and vessel,it is helpful to surgical operation and evaluate the curative effect of the operation.The combination of CT and MRI could improve the accuracy rate of the preoperative diagnosis on chordoma.