椎管内神经源性肿瘤的MRI分析

MR Imaging of Neurogenic Tumor from Intra - Vertebral Canal.

目的:提高MRI对椎管内神经源性肿瘤定性和定位诊断的准确率。材料与方法:神经源性肿瘤27例(男13例,女14例;年龄7-68岁),经病理证实其中神经鞘瘤18例,神经纤维瘤9例,所有病例最初均经采用快速SE T_1加权和T_2加权序列行MR成像,其中5例还附加作了增强扫描。结果:神经鞘瘤和神经纤维瘤在T_1加权像上未见特征性表现,但在T_2加权像上多数表现为有短T_2低信号的包膜内有长T_2信号或混杂信号,长T_2信号强度与脑脊液者相似。同时,还通过MRI找出了椎管内神经源性肿瘤的分布、位置、形态特征等。结论:神经鞘瘤和神经纤维瘤都有赖以增强的MRI可证实的恒定的增强与形态特征,因此MRI,尤其是增强的MRI可用于判定神经源性肿瘤的性质与位置。

Purpose: To elevate the diagnostic accuracy of MRI in identifing the quality and the location of neurogenic tumor from intra -vertebral canal. Materials and Methods: Twenty-seven patients(13 men, 14 wom en; aged 7-68 years) with neurogenic tumor in whom 18 cases of neurolemmoma and 9 cases of neurofibroma were proven by postoperative pathologic diagnoses, underwent initially T1 and T2 weighted spin - echo MR imaging and 5 cases of them, also underwent additionally enhanced T2 weighted MR imaging. MR findings of neurolemmoma and neurofibroma in all patients were analyzed and compared with pathologic results. Results: Characteristic findings of neurogenic tumor on T1 WI were not found but in the case of most neurogenic tumer, long T2 signal that occurred in capsule with short T2 low intensity signal, or mixed signal, were found on T2 WI. The intensity of long T2 signal was similar to that of cerebrospinal fluid. In addition, the features of distributions, locations, and forms of neurogenic tumor from intra - vertebral canal were found by MRI. Conclusions: Neurogenic tumors have consistent enhancement and morphologic features that can be demonstrated with enhanced MR imaging, therefore, MR imaging, particularly enhanced T2 weighted MR imaging can be used for identifing the quality and the location of neurogenic tumor from intra - vertebral canal.