骶骨肿瘤的MRI诊断(附29例报告)  

MRI of the sacral tumors(report of 29 cases)

作　　者：谢道海[1] 倪才方[1] 傅引弟[1] 丁乙[1] 

机构地区：[1]苏州医学院附属第一医院影像中心，215006

出　　处：《中华放射学杂志》2000年第11期731-733,共3页Chinese Journal of Radiology

摘　　要：目的　探讨MRI对骶骨肿瘤的诊断和鉴别诊断的价值。方法　回顾分析了 2 9例骶骨肿瘤的影像学表现。 17例原发骶骨肿瘤均经手术病理证实 ,其中脊索瘤 5例 ,巨细胞瘤 1例 ,神经鞘瘤 3例 ,神经节细胞瘤 2例 ,神经源性肉瘤 1例 ,淋巴肉瘤 4例 ,骨肉瘤 1例 ;12例转移性肿瘤临床均有明确的原发肿瘤病史。所有病例均行MRI、CT及平片检查 ,分析其MRI表现。结果　 (1) 5例脊索瘤中 4例未累及S1节段 ,1例巨细胞瘤累及S2～ 3,6例神经源性肿瘤累及S1～ 3,且包括S1节段。(2 ) 2 9例肿瘤在T1WI均呈中等偏低信号 ,T2 WI呈混杂信号。 (3) 6例神经源性肿瘤均表现为骶孔扩大 ,其他肿瘤表现为不同程度的骶孔破坏。 (4 ) 6例神经源性肿瘤 4例可见骶管扩大。其他骶骨肿瘤也有不同程度的骶管破坏。 (5 ) 16例表现为中央型 ,9例表现为偏心型 ,4例表现为混合型。 (6 )骶骨肿瘤于MRI矢状面的分节现象 :4例神经源性肿瘤表现为按残存椎间盘水平分节 ;12例转移瘤表现为肿瘤按椎体水平分节 ;5例脊索瘤表现为肿瘤内部分节。其他 6例肿瘤未见分节。结论　MRI的多断面成像对骶骨肿瘤显示清晰 ,有利于显示骶骨肿瘤的分型、分节现象以及骶孔扩大和破坏情况 ,与CT及平片比较 。Objective To explore the value of the diagnosis and differential diagnosis of the sacral tumors with MRI. Methods Twenty nine patients with histologically proven sacral tumors were viewed, including sacral chordoma( n =5), giant cell tumor( n =1), neurilemmona( n =3), ganglioneuroma( n =2), malignant lymphoma( n =4), osteosarcoma( n =1), malignant neurilemmoma ( n =1), and secondary tumors ( n =12).All patients were examined with MR,CT and plain radiograph. MR findings were analyzed. Results (1) sacral tumors involved sacral bone with a regularity. Four patients with sacral chordoma involved usually above S3 level, not including S1 bone. One patient with giant cell tumor involved S2 S3. Six patients with neuromas involved S1 S3, including S1 bone. (2) signal intensity: moderate and/or low signal on T 1 weighted images, mottled signal on T 2WI. (3) sacral pores were destructed, disappeared, or enlarged. Sacral pores enlarged in six patients with neuromas, destructed in others. (4) sacral canal were destructed, disappeared, or enlarged. (5) tumors were classified into central ( n =16), centrifugal ( n =9), and mixed ( n =4) types. (6) sacral tumors were segmental on sagittal MR images. Conclusion MRI is superior to CT and plain X ray in assessing classification, segment and sacral pores and the like, so MRI is very important to the diagnosis and the differential diagnosis of the sacral tumors.

关 键 词：骶骨肿瘤 磁共振成像 诊断显像 病例报告 

分 类 号：R738.104[医药卫生—肿瘤] R730.44[医药卫生—临床医学]