颅底脊索瘤的CT和MRI影像诊断与鉴别诊断

目的探讨颅底脊索瘤CT与MR影像学诊断与鉴别诊断。方法回顾性分析13例经病理证实的颅底脊索瘤的CT与MR影像学资料。结果13例脊索瘤中,发生在斜坡5例,鞍区4例,颅中凹2例,鼻咽部1例,蝶窦1例。肿瘤的形态以不规则形最多8例,圆形3例,椭圆形2例。病灶边界清楚9例,边缘模糊4例。MR表现为T1WI呈低、等、高混杂信号,T2WI则以高、低混杂信号为主。增强后病灶呈轻到中度强化,强化信号不均匀。CT见病灶呈不均匀等或稍高密度肿块,7例可见不同程度的骨质破坏。结论颅底脊索瘤的CT和MR表现有一定的特征性,结合临床大多可以确诊,但需与脑膜瘤、垂体瘤、鼻咽癌、软骨类肿瘤等鉴别。

CT and MR Imaging Diagnosis and Differential Diagnosis of Chordomas in the Skull Base

Objective To analyze CT and MR imaging diagnosis and differential diagnosis of chordomas in the skull base.Methods CT and MR findings in 13 patients with pathologically proved chordomas in the skull base were retrospectively analyzed.Results Of 13 cases,the tumors located in clivus in 5,in the sella turcica in 4,in the middle cranial fossa in 2,in nasopharynx in 1 and in sphenoidal sinus in 1.The tumors were irregular in 8,round in 3 and oval in 2.Nine tumors had well-defined margin and 4 with ill-defined margin.The lesions were mixed with iso-,hypo-and hyper-signal intensity on T1WI,hypo-,hyper-signal intensity on T2WI,slight to moderate enhancement revealed in all patients.The lesions were inhomogeneous iso-or slight hyper-intense on CT,and 7 had bone destruction.Conclusion The chordoma in the skull base in of certain characteristics on CT and MR imaging,it can be diagnosed combined with clinical data,but it should be differentiated from meningioma,pituitary tumor,nasopharyngeal carcinoma and chondroid tumor.