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髓内脂肪瘤约占原发性脊髓肿瘤的2~5%,通常需要手术探察确诊.新影像技术的采用,使本病的术前诊断成为可能.本文讨论磁共振影像(MRI)的确诊价值和显微外科的治疗效果.男,27岁.进行性右腿外侧感觉减退、轻度行走困难5个月.检查:左侧肢体呈轻度痉挛状态,痛温觉减退.CSF蛋白368mg/dl.X线平片仅示第1骶椎裂.颈部肌电图证实颈—胸接合部髓内有一大的占位性损害.MRI显示一髓内肿瘤延及C_6~T_2.瘤组织的高强度信号,可作为脂肪瘤组织之特征.手术证实了MRI所见.以显微外科技术行肿瘤次全切除.显微镜检证实为血管脂肪瘤.术后仅留左C_8神经根损伤.脂肪组织的良性肿瘤—髓内脂肪瘤罕见.可能来自原始多能间质细胞,分化而成脂肪瘤或血管瘤,
Intramedullar lipoma accounts for about 2% to 5% of primary spinal cord tumors and usually requires surgical exploration to confirm the diagnosis. The use of new imaging techniques makes preoperative diagnosis of the disease possible. This article discusses the definitive value of magnetic resonance imaging (MRI). And microsurgical treatment effect. Male, 27 years old. Progressive left leg lateral hypoesthesia, mild walking difficulties 5 months. Check: The left side of the limb showed a mild spasm, pain and temperature perception decreased. CSF protein 368mg/dl X-rays showed only the first fissure. The cervical electromyography confirmed a large space-occupying lesion in the cervical-thoracic junction. MRI showed an intramedullary tumor extension and C_6 ~ T_2. High tumor tissue. Intensity signal, can be used as a characteristic of lipoma tissue. The operation confirmed the MRI findings. Microsurgical techniques were used to perform subtotal tumor resection. Microscopic examination confirmed angiolipoma. Left only C_8 nerve root injury after injury. Adipose tissue Benign tumors are rare in intramedullary lipomas. They may come from primitive pluripotent mesenchymal cells and differentiate into lipomas or hemangiomas.