颅底脊索瘤的CT、MR影像诊断

CT and MR Imaging of Chordomas in the Skull Base

目的 探讨CT、MR对颅底脊索瘤的诊断价值。方法 回顾性分析 71例病理证实的颅底脊索瘤的CT、MR影像表现及特点。结果 71例脊索瘤中 ,发生在斜坡 3 9例、鞍区 18例、颅中凹 12例和颈静脉孔区 2例。 3 7例肿瘤内可见小囊变、坏死灶。 2 1例经MR检查者见肿瘤内有小出血灶。 63例可见邻近骨结构破坏。 5 0例经CT检查的病例中 ,4 1例可见肿瘤内有斑块样高密度钙化影。 2 7例可见非均匀性轻度增强 ,肿瘤边缘清楚 ,3 9例肿瘤呈非均匀性中度增强 ,5例表现为较均匀性中度增强。结论 CT显示肿瘤钙化优于MR ,但在显示骨破坏上二者相同。在显示肿瘤生长方式以及肿瘤与邻近结构的解剖关系上MR明显优于CT。

Objective To delineate the CT and MR imaging features of chordomas in the skull base. Methods CT and MR imaging studies of 71 patients with the chordomas arising from the skull base. Results In this series of 71 chordomas,39 located in the clival region,18 in the sella turcica,12 in the middle cranial fossa and 2 in the region of jugular foramen.The cystic components or necrosis were intratumoral in 37 patients and bony invasion in 63 cases.Intratumoral calcification was found in 41 cases with CT examination and hemorrhage in 21 cases with MR scan.Slight heterogeneous enhancement was found in 27 cases,intermediate heterogeneous enhancement in 39 and intermediate homogeneous enhancemet in 5. Conclusion CT was able to find intratumoral calcification. MRI was superior to CT for delineating the growth style of the tumor and its relationship to the surrounding anatomic structures. [