髓外硬膜下三种常见肿瘤MRI征象的再认识(附22例分析)  

Re-recognition of MRI Signs of Three Common Extramedullary-intradural Tumors

作　　者：田顺典[1] 李宁富[1] 刘闽生[1] 杜玉秀[1] 

机构地区：[1]宁夏医学院附属医院放射科MRI室

出　　处：《实用放射学杂志》1998年第6期333-336,共4页Journal of Practical Radiology

摘　　要：目的：对本院２２例髓外硬膜下肿瘤之ＭＲＩ征象进行回顾性分析，进一步总结ＭＲＩ诊断经验。方法：病例含神经鞘瘤１１例，神经纤维瘤９例，脊膜瘤２例。皆经手术、病理证实。文章对三类肿瘤之ＭＲＩ表现进行比较并归纳误诊原因。结果：脊膜瘤年龄偏大，瘤体以宽基部附着于硬脊膜，强化显著。鞘瘤多呈类圆形，有包膜，３ｃｍ以下者居多。神经纤维瘤年龄较轻，卵圆及不规则形多见。后两种瘤内部均见纤维信号区域，多不均匀性增强。２２例术前ＭＲＩ确诊率为５０％，误诊常在鞘瘤与神经纤维瘤之间。结论：ＭＲＩ多方位增强成像，有助于充分反映肿瘤特征是减少误诊之关键。但鞘瘤与单发神经纤维瘤之鉴别。Objective:A retrospective analysis of MRI signs of 22 cases of extramedullary-intradural tumors was made for further summing-up of experience of MRI diagnosis of these tumors.Methods:In this study there were 11 cases of neurilemmoma,9 cases of neurofibroma and 2 cases of meningioma,all proved by surgically and pathologically.The MRI signs were summed-up and compared,and the causes of misdiagnosis were analyzed.Results:The cases of meningioma were of older age,the tumor mass had broad dural base and enhanced homogeneously.Neurilemmomas were mostly roundish in shape,less than 3 cm in diameter,and with visible capsule.The cases of neurofibroma were of younger age,the tumor masses were mostly ovoidal or irregular in shape,larger than 3 cm.Both of the latter had areas of fibrous tissue signal with in the tumors and were inhomogeneously enhanced.The overall MRI preoperative diagnostic rate was 50%,and misdiagnoses were mostly between neurilemmomas and neurofibromas.Conclustion:Multiplanar MRI scan with contrast enhancement is helpful in depicting the characteristic features of the tumors,and is the key to reduce the misdiagnostic rate.But differential diagnosis between neurilemmoma and solitary neurofibroma,solely based on MRI signs,can still be difficult.

关 键 词：椎管内肿瘤 髓外硬膜下肿瘤 诊断 NMR 

分 类 号：R739.420.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]