椎管内皮样囊肿脂滴破入脊髓中央管和蛛网膜下腔的诊断和治疗  

Diagnosis and treatment of ruptured intraspinal dermoid tumour with fat droplets in the central spinal canal and subarachnoidal space

作　　者：初明[1] 魏兰兰[2] 胡恩喜[1] 王殿洪[1] 于洪伟[1] 吴培[1] 徐坤[1] 李国忠[1] 钟震宇[1] 史怀璋[1] 赵世光[1] 

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,150001 [2]哈尔滨医科大学基础医学院

出　　处：《中华临床医师杂志（电子版）》2011年第20期5950-5954,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：黑龙江省教育厅基金资助项目(10551189);黑龙江省科技厅留学基金(LC201014);哈尔滨医科大学附属第一医院科研基金(2009L04)

摘　　要：目的探讨椎管内皮样囊肿破裂脂滴进入脊髓中央管和蛛网膜下腔的诊断和治疗。方法回顾性分析9例症状性破裂椎管内皮样囊肿的临床资料。结果影像学检查显示破入脊髓中央管的游离脂滴在T1WI上呈高信号,T2WI上信号略有衰减,脂肪抑制序列呈极低信号。患者均经MRI和手术证实为腰骶部椎管内皮样囊肿伴脂滴破裂进入脊髓中央管和(或)蛛网膜下腔,术后随访1～4年(平均2.3年),患者KPS评分较术前有所提高。结论皮样囊肿破入脊髓中央管和(或)蛛网膜下腔的MRI表现具有特异性,当患者出现症状性椎管内皮样囊肿破裂,应及时给予手术治疗。Objective To study the diagnosis and treatment of ruptured intraspinal dermoid tumour with fat droplets in the central spinal canal and subarachnoidal space.Methods To review the clinical characteristic and therapeutic outcome of nine intraspinal dermoid tumors in the First Affiliated Hospital of Harbin Medical University.Results Free fat droplets within spinal cord central canal demonstrated high signal intensity on T1WI,slight declined signal intensity on T2WI,and extremely low signal on fat suppression sequence.Patients were confirmed by MRI and surgery of ruptured intraspinal dermoid tumour with fat droplets in the central spinal canal and/or subarachnoidal space,patients were followed up 1 to 4 years (average 2.3 years),with KPS scores of patients increased.Conclusions Intraspinal dermoid ruptured in the central spinal canal and/or subarachnoidal space have specific appearance on MRI,when a symptomatic ruptured dermoid tumor is suspected,surgical treatment should be recommended.

关 键 词：椎管内皮样囊肿 脊髓 自发破裂 脂滴 

分 类 号：R739.4[医药卫生—肿瘤]