脊髓原发性原始神经外胚层肿瘤的MR影像特征及相关文献分析  

MRi maging features of pri mary pri mitive neuroectodermal tumors in the spinal cord and literature review

作　　者：叶进湖[1] 戴建平[1] 李少武[1] 马军[1] 艾林[1] 秦海强[1] 李鑫[1] 孙辉[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经放射科,北京100050

出　　处：《中国医学影像技术》2007年第9期1296-1299,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的研究脊髓原发性原始神经外胚层肿瘤（PNET）的MR特征。方法4例脊髓原发性PNET术前均行MR常规平扫及增强检查。结果发病年龄：13-46岁,中位年龄26.5岁。病灶部位：2例肿瘤位于胸段,1例肿瘤位于颈胸段,1例肿瘤位于圆锥。MR影像表现：3例表现局部占位征象,1例表现为脊髓弥漫性增粗;4例肿瘤均位于脊髓的中心,与周围正常脊髓分界不清,且周围无明显水肿;在T1WI上,呈等信号或稍低信号,T2WI上呈稍高信号或高信号;病变尾侧继发囊变1例;增强MR,3例病变明显强化,1例轻度强化。结论脊髓原发性PNET好发于成人,可位于髓内,或髓内外,或呈外生性生长,并可发生于脊髓的各个节段,其中胸段脊髓及圆锥常见,MR影像没有特异性征象,最后确诊需病理诊断。Objective To determine the MR imaging features of primary PNET in the spinal cord. Methods We retrospectively reviewed MR imaging studies of 4 histologically and clinically confirmed primary PNETs in the spinal cord. All four patients underwent spinal MR study before and after injection of contrast agent preoperatively. Results The patients＇ ages ranged from 13 to 46 years with a median of 26.5 years. On MR image, two tumors were located in the thoracic cord with the other two in the conus medullaris and the cervicothoracic cord, respectively. And focal mass effect was found in three tumors while diffuse enlargement of the spinal cord was seen in one tumor. Among the four tumors, cystic area was present and extended caudal from the tumor in only one case. They were all located at the center of the spinal cord with an ill-defined margin and no apparent peritumoral edema. And all of them were hypo to isointense on Tl-weighted images, and hyperintense on T2-weighted images. After contrast, moderate or marked enhancement was found in three of them, while slight enhancement in the rest one. Conclusion Primary PNETs of the spinal cord appear to be more common in adults than in children and may be intramedullary or exophytic or combined intramedullary extramedullary. In addition, they may be 1o cated at all levels of the spinal cord with the thoracic spinal cord and conus medullaris being the most common. But none of their MR imaging features was pathognomonic and the final diagnosis depends on surgical pathology.

关 键 词：原始神经外胚层肿瘤 脊髓肿瘤 磁共振成像 诊断 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]