MRI与CT在颅底脊索瘤诊断中的价值

目的：分析发生在颅底部脊索瘤的MRI和CT表现，以探讨MRI和CT在颅底部脊索瘤诊断中的价值。方法：搜集22例证实的病例，其中男性13例，女性9例，最大年龄67岁，最小年龄13岁，平均年龄42岁。22例均行MRI平扫和增强检查，其中7例进行了GT检查。结果：肿瘤发病部位主要位于斜坡及其周围区域，其中斜坡15例、鞍内2例、鞍旁1例、颈静脉孔区2例、蝶窦1例、鼻咽部1例。肿瘤的形态以不规则形最多16例，圆形4例，椭圆形2例。病灶边界清楚15例，边缘模糊7例。MRI表现T1WI呈低、等、高混杂信号，T2WI以高、低信号为主，其中18例呈混杂信号，4例表现为信号均匀。增强后病灶呈不均匀轻到中度强化，强化信号不均匀。CT病灶呈不均匀等或稍高密度肿块，均见不同程度的骨质破坏。结论：MRI由于有多轴面成像的优势，可以准确显示颅底脊索瘤的大小、形态、边界及其信号特点。CT在显示病灶的骨质破环、残存骨质方面较MRI具有优势。因此，MRI和CT相结合在颅底脊索瘤的诊断中具有很大的价值。

Evaluation of MRI and CT in diagnosing chordoma in the skull base

Objective:To investigate the value of MRI and CT in the diagnosis of chordomas in the skull base by analyzing their MRI and CT appearances.Methods:Twnety-two cases of chordomas, proven surgically and pathologically in our hospital,are analyzed retrospectively.The age of 13 men and 9 women ranged from 13 to 67 years(mean 42 years). 22 patients underwent MRI examinations with and without intravenous injection of contrast media,7 patients underwent CT plain examinations.Results:15 tumors located in clivus,2 in intrasellar,1 in parasellar region,2 in jugular foramen, 1 in sphenoidal sinus,1 in nasopharynx; 16 tumors with irregular shape,4 with round shape, 2 with oval shape;15 tumors with well-defined margin,7 with ill-defined margin;18 patients dispiay inhomogenenous signal ,with iso-,hypo-and hyper-intense signal on T 1WI while hypo-,hyper-intense signal on T 2WI;4 patients show homogenenous signal,with iso-,hypo-intense signal on T 1WI while hyper-intense signal on T 2WI; slight to moderate enhancement revealed in all patients;7 patients bone invasion on CT.Conclusion:Owing to multiplanar imaging,MRI show correctly size,shape, margin and signal of tumors. CT show bone invasion easier than MRI. MRI combined CT are of great value in the diagnosis of chordomas.