马尾神经区肿瘤MR诊断探析

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1、马尾神经区肿瘤MR诊断探析【关键词】马尾神经摘要：目的：探讨马尾神经区肿瘤MR的表现特征，提高MR影像诊断及鉴别诊断水平。方法：分析经病理或临床证实确诊的50例马尾神经区肿瘤的MR表现特征。结果：脂肪瘤15例中12例合并先天畸形，2例可见马尾被包绕，2例无规律，3例MRM旋转呈矢状位可见蛛网膜下腔于一侧受压变窄。神经鞘瘤13例中有10例有囊变，增强扫描实质部分强化明显；2例马尾神经鞘MRM旋转观察示肿瘤上、下方的“脑脊液柱”里“杯口”状截断。神经纤维瘤7例中3例多发，肿瘤T1WI呈等或低信号，T2WI呈等或稍高信号。室管膜瘤5例，T1WI呈等或稍高信号，T2WI呈高信号，1例有囊变。脊膜瘤

2、4例增强扫描呈明显强化，其中1例可见“脊膜尾征”,马尾显示欠佳。多发转移瘤2例MRM中示马尾神经区多发充盈缺损。胆脂瘤，副神经节瘤，淋巴瘤及血管瘤各1例，其中胆瘤无强化。结论：MR可清晰显示马尾神经区肿瘤的形态、MR信号特征、与马尾神经的关系及马尾的各种变化，对其诊断的鉴别诊断有较高价值。关键词:椎管肿瘤；马尾;磁共振成像ExplorationtheDiagnosisofMRofCaudaTumorsEquinaHUANGXun,WUChe-fu,XIEQun-xian(TheDepartmentofRadiology,ZhanjiangCentralPeople"sHospital,Gu

3、angdongZhanjiang524001,China)Abstract:Objective:Inordertoimprovedingnosticability,theMRimagingfindingofcaudatumorswerestudied.Method:50pathologicallyclinicallyconfirmedcasesoftumorsinthecaudaareawereexaminedwithMRimaging.Results:Lipomaoccurredin15casesofourseriesofpatientsand12casesoutofthe15showe

4、dcongeniteddefectofvariouskindssimuItaneously,lipomaenclosedthecaudaequinain2cases,MRMdemonstratedextradurallipomain3cases.Among13casesofneurinomatherewascysticformatoin10cases,constrast-enhancedimagesshowthatthetumaswasintensivelyhomogenowswithrimenhancement,MRMdemonstratedtheintraduralneurinomas

5、appearedasfillingdefectandweresharplyoutlinebycerebrospinalfluidin2cases.7caseofneurofribromawerefoundandtheremultiplelesionsin3case・ThetumormassshowedhypointenseonT1WIandhyperorisointenseonT2WI.Therewere5casesofependymoma,EpendymomaofthefilumshowedhomogenoushyperintenseassligntlyhyperintenseonT2W

6、I.Therewascysticformationinthemassofonecaseofependymoma・Therewere4casesofmeningioma・Thetumormassshowedhomogenousenhancementaftercontrastenhaneedsearmingandmeningealtailsignwasfoundinonecase・MRMshowedmultipiesmallintraduralextramedullarynodulesinthecaudaepuinashowingfillingdefectssharplyout-linebyC

7、SFin2cases・onecaseofhemangioblastomashowedisointenseonT1WIandhyperintenseofT2WIrelativetoCSF.anditexhibitedhemogenousenhancementafterGd-DTPAinjectiori.Inaddition,onecaseofparaganiomaandlymphomaandcholesteationwit