脊髓室管膜下瘤与星形细胞瘤的MRI对照

Comparision between intramedullary subependymoma and astrocytoma on MR imaging

目的对比观察脊髓室管膜下瘤与星形细胞瘤的MRI表现。方法回顾性分析12例脊髓室管膜下瘤和30例星形细胞瘤的平扫和增强MRI表现及临床资料,对比分析二者发病年龄、性别分布、病变部位、病变纵轴长度、椎体数目、生长方式、T1WI信号、T2WI信号、有无强化、边界是否清楚、是否有囊变、是否有脊髓空洞、是否有瘤周水肿的差异。结果脊髓室管膜下瘤与星形细胞瘤发病年龄、性别分布、病变部位、T1WI信号、T2WI信号差异均无统计学意义(P均>0.05)。脊髓室管膜下瘤纵轴长度大于星形细胞瘤(t=3.21,P<0.05),椎体数目亦多于星形细胞瘤(t=2.58,P<0.05);脊髓室管膜下瘤多无强化、呈偏心生长、边界清、无囊变及瘤周水肿,与星形细胞瘤比较差异均有统计学意义(χ2=6.43、10.63、15.42、4.67、13.67,P均<0.05)。两种肿瘤脊髓空洞均少见。结论肿瘤生长方式、边界及瘤周水肿等MRI表现有助于鉴别脊髓室管膜下瘤与星形细胞瘤。

Objective To compare the MR imaging appearances of intramedullary subependymoma and astrocytoma.Methods Twelve patients with intramedullary subependymoma and 30 patients with astrocytoma were retrospectively analyzed.Patients＇ age,sex,tumor location,tumor size（longitudinal length and number of vertebral segments involving tumor）,growth pattern,T1 and T2signals,degree of enhancement,tumor margin,as well as the presence of peritumoral edema,tumoral cysts and syringohydromyelia were compared between two neoplasms.Results No statistical difference was found in patient＇s age,sex,tumor location,T1 and T2signals between intramedullary subependymoma and astrocytoma（all P〉0.05）.The size of intramedullary subependymoma was longer than that of astrocytoma（t=3.21,2.58,both P〈0.05）.No enhancement,well-defined margin,eccentric growth pattern were more common in intramedullary subependymoma.However tumoral cyst and peritumoral edema were less common in intramedullary subependymoma.These five characteristics were statistically different with astrocytoma（χ^2=6.43,10.63,15.42,4.67,13.67,all P〈0.05）.Syringohydromyelia was less common in both intramedullary subependymoma and astrocytoma with no statistical difference.Conclusion MRI features including growth pattern,peritumoral edema and tumor margin are helpful to differentiate intramedullary subependymoma from astrocytomas.