脊柱外周型原始神经外胚层肿瘤影像学表现(7例报告)  

Imaging features of peripheral primitive neuroectodermal tumors of spinal column:Report of 7 cases

作　　者：陈婉琪[1] 吴元魁[1] 许乙凯[1] 李维粤[1] 肖翔[1] 代月黎[1] 马立超[1] 

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515

出　　处：《中国介入影像与治疗学》2014年第10期656-659,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察脊柱外周型原始神经外胚层肿瘤（pPNET）的影像学表现。方法回顾性分析7例经病理证实的脊柱pPNET患者的影像学资料。结果 7例脊柱pPNET病例中,男性4例,女性3例。病变位于颈段（C2～7）1例,颈胸段（C7～T2）1例,胸段（T10～12）1例,腰段（L3～4、L4～5）2例,腰骶段（L1～S2）1例,骶段（S1～4）1例;其中,髓外硬膜内1例,硬膜外6例。MR（n=7）和CT（n=4）检查表现为硬膜内或硬膜外肿块,信号/密度不均,T1WI为等或稍低信号,T2WI为稍高信号,CT为等密度,增强扫描呈不同程度不均匀强化。肿瘤位于髓外硬膜内者可伴有多发蛛网膜下腔转移,硬膜外pPNET肿瘤的主体部分多位于椎骨或椎旁组织,肿块椎管内部分累及多个椎体平面,并通过椎间孔、骶孔与椎旁部分沟通。结论脊柱pPNET可表现为髓外硬膜内或硬膜外肿瘤,确诊依赖病理及免疫组化检查。Objective To observe the imaging findings of peripheral primitive neuroectodermal tumors（pPNET）of spinal column.Methods Seven patients with pathologically proven spinal pPNET were retrospectively reviewed.ResultsAmong seven patients,4were males and 3were females.The imaging data included MRI（n=7）and CT（n=4）.The lesions were located in cervical（C2—7,n=1）,cervicothoracic（C7—T2,n=1）,thoracic（T10—12,n=1）,lumbar（L3—4,L4—5,n=2）,lumbosacral（L1—S2,n=1）and sacral（S1—4,n=1）,while 1was intradural extramedullary tumor,6were epidural neoplasm.CT scan and MRI showed intradural extramedullary tumor or epidural neoplasm,tumor entity mostly appeared heterogeneous in density/signal.The mass showed iso-intensity or hypo-intensity on MR T1 WI,heterogeneous high signal on T2 WI.Both contrast-enhanced CT and MRI presented varying degree of inhomogeneous enhancement.Spine pPNET radiological imaging depicted an intradural,extramedullary large mass with multiple metastatic tumors on the surface of brain and spinal cord,or an extradural irregular mass which extended outward from intervertebral foramen and sacral foramen,and connected with the main part in paraspinal soft tissues or vertebral bones.Conclusion Spine pPNET might present as intradural,extramedullary or epidural neoplasm,the definite diagnosis is depended on the pathology and immunohistochemical results.

关 键 词：脊柱 神经外胚瘤 原始 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.43[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2