摘要
目的探讨胸腰段椎管内肿瘤的临床特征和磁共振成像(MRI)的诊断价值分析。方法回顾性分析2014年1月至2016年2月27例经手术和病理确诊为胸腰段椎管内肿瘤患者的临床资料和MRI影像学资料。结果首发症状包括腰背部胀痛、下肢麻木无力、大小便功能障碍、感觉异常或痛觉减退等,症状多进行性加重,有由上至下扩散的特点。27例患者经病理证实髓内肿瘤5例,硬膜外肿瘤3例,髓外硬膜下肿瘤19例,MRI定位准确26例(96.30%),定性准确21例(77.78%)。MRI扫描髓内肿瘤多呈等T1、等长T2异常信号,髓外硬膜下肿瘤多呈等低T1信号、等高T2信号,增强扫描后多显示环状或不均匀强化。硬膜外肿瘤包括血管瘤和结核性肉芽肿,血管瘤呈等T1信号高T2信号,结核性肉芽肿呈略低T1信号、等长T2信号。结论胸腰段椎管内肿瘤早期临床特征不典型,MRI诊断定位准确率和定性准确率均较高,是椎管内肿瘤诊断的有效方法。
Objective To investigate the clinical characteristics of intraspinal tumor and diagnostic value of MRI . Methods The clinical data and MRI image data about 27 patients who were diagnosed as thoracolumbar intraspinal tumor by surgery and pathological examination in our hospital from January 2014 to December 2015 were retrospectively analyzed . Results The initial symptoms included lower back pain , numbness and weakness in lower limbs , bowel and bladder dysfunction,paresthesia loss and hypalgesia , etc, moreover, these symptoms had a trend of progressive aggravation and top-down diffusion.The pathological examination showed that among 27 patients,there were 5 cases of intramedullary tumors ,3 cases of epidural tumors and 19 cases of intradural tumors in whom there were 26 cases of accurate location by MRI （96.30%）,26 cases of accurate qualitation by MRI （77.78%）.MRI scanning showed that the other intramedullary tumors presented equal T1,equal long T2 abnormal signals,and epidural extramedullary tumors presented equal low T1 signal, equal high T2 signal, and enhanced scanning showed cyclic or inhomogeneous enhancement .The epidural tumors included hemangiomasand tuberculous granulomas in which hemangiomas showed equal T1 signal and high T2signal, however tuberculous granulomas showed slightly lower T1 signal or equal long T2 signal.Conclusion The early clinical symptoms of thoracolumbar intraspinal tumor are atypical , however ,the positioning accuracy rate and qualitative accuracy rate of MRI in diagnosis of intraspinal tumor are higher ,thus,which is an effective method to diagnose intraspinal tumor .
出处
《河北医药》
CAS
2017年第3期342-345,共4页
Hebei Medical Journal
关键词
胸腰段脊髓
椎管内肿瘤
临床特征
磁共振成像
诊断价值
thoracolumbar spinal cord
intraspinal tumor
clinical features
magnetic resonance imaging
diagnostic value
