椎管内神经源性肿瘤的MR征像分析与脊膜瘤对照研究

Analysis and comparative study of MR findings of neurogenic tumors and with meningioma in spinal canal

目的 :通过高场强MR对椎管内神经源性肿瘤的表现特征进行分析 ,并与脊膜瘤的MR表现进行对比研究 ,以期总结本病的MR表现特征及与脊膜瘤鉴别诊断要点。方法 :经手术病理证实神经源性肿瘤 2 3例及脊膜瘤 18例患者行自旋回波T1加权及T2 加权序列进行扫描 ,常规行矢状位扫描 ,必要时加扫轴位和 /或冠状位。所有病例均通过MR图像对肿瘤的部位、形态、大小、边界、信号、是否发生坏死囊变、椎间孔改变及增强后强化情况进行观察分析。结果 :2 3例神经源性肿瘤中发生于颈、胸椎节段 19例 ,所有病例均位于椎管两侧 ,肿瘤呈长圆形 12例 ,15例肿瘤引起椎间孔扩大 ,病灶平均长度 3.42cm ,肿瘤信号呈等T1信号 17例 ,长T1信号 5例 ,短T1信号 1例 ,等T2 信号 2例 ,长T2 信号 2 1例 ,病灶发生斑点状坏死 5例 ,斑片状坏死 8例 ,明显囊变 2例 ,15例经增强扫描病例呈明显不均匀强化 7例 ,均匀强化 8例。 18例脊膜瘤病灶位于颈段 6例 ,胸段 12例 ,肿瘤位于脊髓前或后方 11例 ,病灶直径平均 1.89cm ,椎间孔均无扩大改变 ,病灶信号均匀 13例 ,呈等T1信号 17例 ,等T2 信号 9例 ,略长T2 信号 9例 ,仅 1例病灶内可见斑点状坏死 ,明显均匀强化 14例。结论 :椎管内神经源性肿瘤具有较特征性的MR表现 ,与脊膜瘤MR表现有明显不同点 ,?

Objective:To analyze the MR findings of neurogenic tumors in spinal canal and compare with meningioma.Methods:Twenty-three patients with neurogenic tumors , which were confirmed surgically and pathologically were studied and compared with 18 cases with meningioma in spinal canal. All cases were examined by SE T 1 and T 2 weighted sequences. Sagittal scanning of the spine was of routine in aid of transverse and coronal scanning if necessary. The location, shape,size, edge, signal, necrosis, intervertebral foramen and enhancement change on the MR images were observed and analyzed.Results:The neurogenic tumor located in cervical and thoracic spinal canal in 19 of 23 cases and situated bilaterally in all cases. The tumors were oval in shape in 12 cases. Enlargement of intervertebral foramen were showed in 15 cases, and the signal of the lesions was isointense in 17 cases, hypointense in 5 cases and hyperintense in I case on T 1 weighted images and isointense in 2 cases and hyperintense in 21 case on T 2 weighted images respectively. Necrosis was found in 13 cases and cyst in 2 cases.There were 7 cases with marked heterogeneous enhancement and 8 cases with intensive homogeneous enhancement in 15 cases. Of 18 cases with meningioma, 6 cases were found that the tumors were located in cervical spinal canal and 12 cases in thoracic region. The tumors lay anteriorly or posteriorly to the spinal cord, and were isointense in 17 cases on T 1 weighted images and isointense in 9 cases and slight hyperintense in 9 cases on T 2 weighted images.Conclusion:The neurogenic tumors had many characteristic MR findings. There were distinctive difference between the two neoplasms and the differentiation diagnosis could be made on MRI.