斜坡脊索瘤螺旋CT表现及鉴别诊断

The spiral CT manifestations and differential diagnosis of clivus chordoma

目的探讨螺旋CT在斜坡脊索瘤诊断及鉴别诊断中的价值。方法分析11例经手术病理证实斜坡脊索瘤的螺旋CT资料。结果 11例中,肿瘤位于上斜坡区3例,同时累及上、中斜坡区7例,累及中、下斜坡区仅1例。肿瘤形态以不规则、分叶状为主,大小不一。肿瘤骨质破坏区,边缘较清晰,但不锐利,骨质破坏旁软组织肿块侵及、压迫颅内组织时,与颅内正常组织交界不清。肿瘤密度混杂,11例均见斜坡不同程度的骨质破坏,邻近可见软组织肿块形成,7例肿瘤内见钙化或残存骨,对周围正常结构均产生不同程度的侵及、压迫、包绕表现。结论螺旋CT对斜坡脊索瘤的诊断及鉴别诊断有着重要的价值。

Objective To study the value of spiral CT in the diagnosis and differential diagnosis of clivus chordoma. Methods The spiral CT data of 11 cases of clival chordoma proved by operation and pathology were analyzed in this work. Results Of these 11 patients, 3 located in the upper slope region at the same time, 7 cases involved in the upper as well as middle slope zone, and on!y 1 involved in the middle as well as lower slope zone. The morphology of the tumor appeared to be irregular, lobulated, and distinct sizes. The destruction of bone occurred in tumor region and the edge was clear, but not sharp. Moreover, the mass invasion into soft tissue adjacent to bony destruction region and oppression of intracranial tissues can be seen, and the intracranial normal tissue junction was unclear. The density of tumors was mixed and the slopes were seen in 11 cases with different degree of bone destruction, with soft tissue mass formation adjacent to the de- struction region. 7 patients with tumors exhibited calcification or remaining bone, which posed different degrees of inva- sion, oppression, and winding performance to the surrounding normal structures. Conclusion The spiral CT possesses important value in the diagnosis and differential diagnosis of clival chordoma.