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目的:探讨脊髓室管膜瘤的MRI特征性表现。方法:对60例经手术及病理证实的脊髓室管膜瘤的MRI表现进行分析。特别对与肿瘤相关的头及尾端的脊髓囊腔的特征进行了分析。结果:肿瘤实体主要位于颈髓(包括部分累及延髓及胸髓)39例;主要位于胸髓(包括部分累及颈髓及腰髓)11例。位于圆锥马尾10例。肿瘤实体沿脊髓纵轴累及由1~10个椎体不等:平均3.7个椎体。在T2WI,60例均为略高信号。注射Gd-DTPA后,47例肿瘤轻度强化;13例明显强化。60例中,54例合并脊髓囊腔。囊腔位于肿瘤两端,居中。近端囊腔较远端囊腔短。近端囊腔累及1~5个椎体,远端囊腔累及2~10个椎体。结论:颈胸髓脊髓室管膜瘤的发生率明显高于下部脊髓,圆锥和终丝。脊髓下段肿瘤以乳头型为主,而脊髓上段肿瘤以上皮型及细胞型为主。与肿瘤相关的脊髓囊腔,特别是上颈段囊腔延伸至延髓(锥体交叉以上),造成第四脑室底部上抬的特有征像。为脊髓室管膜瘤颇具特征性表现。对脊髓囊腔的发生机制进行了分析。
Objective: To investigate the MRI features of spinal ependymoma. Methods: MRI features of 60 cases of spinal ependymoma confirmed by surgery and pathology were analyzed. In particular, the characteristics of the spinal cyst cavity associated with the tumor and the head and tail were analyzed. RESULTS: Tumor entities were mainly located in the cervical cord (including part of the medulla oblongata and thoracic cord) in 39 cases; and mainly in the thoracic cord (including part of the involving the cervical cord and lumbar cord) in 11 cases. 10 cases are located in the conical horsetail. Tumor entities range from 1 to 10 vertebrae along the longitudinal axis of the spinal cord: an average of 3.7 vertebral bodies. On T2WI, 60 cases were slightly higher signals. After Gd-DTPA injection, 47 cases had mild enhancement of tumors and 13 cases had marked enhancement. Of the 60 patients, 54 were associated with a spinal cyst. The cyst is located at both ends of the tumor and is centered. The proximal cyst is shorter than the distal cyst. The proximal cystic cavity involved 1 to 5 vertebral bodies, and the distal cystic cavity involved 2 to 10 vertebral bodies. CONCLUSIONS: The incidence of cervical thoracic, spinal, and ependymoma is significantly higher than that of the lower spinal cord, conus and terminal silk. In the lower segment of the spinal cord, the papillary type is predominant, whereas in the upper segment of the spinal cord, the epithelial type and cell type are predominant. The tumor-associated spinal cyst, especially the upper cervical sac, extends to the medulla oblongata (above the pyramidal cross), causing a characteristic sign of elevation at the bottom of the fourth ventricle. For the spinal cord ependymoma quite characteristic performance. The mechanism of spinal cyst formation was analyzed.