脊髓室管膜瘤和星形细胞瘤的3T MRI诊断

3T MRI Diagnosis for Spinal Cord Ependymoma and Astrocytomas

目的:探讨在3T MRI上脊髓室管膜瘤和星形细胞瘤的特征表现,以提高诊断和鉴别诊断水平。方法:回顾分析16例室管膜瘤和16例星形细胞瘤患者的MR影像资料,所有病例均得到手术病理证实。结果:两者均以T1WI上低、等低信号,T2WI上高、等高信号为主。室管膜瘤中瘤内囊变7例,肿瘤一端或者两端继发囊腔改变9例。星形细胞瘤中瘤内囊变3例,继发囊腔6例。16例室管膜瘤中,位于脊髓中央的14例,位于脊髓一侧有2例。16例星形细胞瘤中,位于脊髓中央6例,位于脊髓一侧有10例。行动态增强后,强化特点为:16例室管膜瘤中境界清晰的7例,境界模糊的9例;轻度强化6例,明显强化9例,1例不强化。其中2例均匀增强,13例强化欠均匀,强化方式2例呈结节状、1例环状、2例斑片状及8例不规则增强。16例星形细胞瘤中,境界清晰2例,境界模糊14例;轻度增强8例,明显增强4例,无强化4例。其中均匀增强1例,不均匀增强11例;5例片状,1例小点状,1例环状,4例不规则强化。结论:3T MRI平扫和动态增强对脊髓室管膜瘤和星形细胞瘤的诊断和鉴别具有重要价值,两者MRI表现有一定的特征性。

Objective：To evaluate the role of 3T MRI in the diagnosis and differential diagnosis of spinal cord ependymoma and astrocytomas.Method：The MRI characteristic of 16 ependymoma cases and 16 astrocytomas cases were retrospectively reviewed,and they were confirmed by operation and patholog.Result：Most of tumors were isointensity in T1WI and mixed intensity in T2WI. 16 cases of ependymal 7 cases had intratumoral cysts in tumors,rostral and caudal cysts were seen in 9 tumors. In 16 astrocytomas appear in 3 cases of changed,and intratumoral cysts in 6 cases had secondary cysts. In 16 ependymomas,located in the central 14 cases of spinal cord,2 cases in spinal cord side. In 16 astrocytomas in 6 cases,located in the spinal cord,10 cases in spinal cord side.Enhance scan,16 cases of ependymomas 7 cases of borders,9 cases margin were not clear. 6 cases of mild strengthening,9 cases significantly improved,and 1 case not improved. Two cases of strengthening uniform,13 cases improved uneven way,nodules in 2 cases,ring in 1 case,two cases of patchy and 8 cases of irregular strengthening. In 16 astrocytomas,2 tumors of clear margin,and 14 tumors margin were not clear,8 cases of mild strengthening,4 cases significantly improved,4 cases without strengthening. One tumor strengthen even,11 cases were uneven strengthening. The strengthing way were 5 sheets,1 case of small dot, 1 case of annular,4 cases of irregular enhencement.Conclusion：3T MRI has important value in the diagnosis of spinal ependymoma and astrocytoma .The MRI performance had certain characteristic.