脊索瘤的多层螺旋CT和MRI影像表现分析

目的总结脊索瘤的多层螺旋CT和MRI影像表现。方法选择我院2010年1月-2016年3月所收治的脊索瘤患者34例作为研究对象。行螺旋CT与MRI检查,对患者多层螺旋CT和MRI影像表现进行总结。结果脊索瘤患者好发部位为颅底与骶尾部,呈不规则分叶状、椭圆状或结节状。CT检查呈不均匀低密度影或低及等密度影,边界清晰,均可见溶骨性及膨胀性骨质破坏,部分可见脊索瘤内点状或斑片状钙化,增强后呈不均匀轻、中度强化。MRI平扫示肿瘤轮廓光整、边缘清晰,T1WI均呈均匀或混杂的低或等信号,T2WI呈明显高信号或等或稍长T2信号,DWI等或高信号,增强扫描呈"颗粒样"轻、中度强化。结论 CT利于显示脊索瘤骨质破坏及瘤内钙化,MRI软组织分辨率高,可显示病灶内囊变、出血、钙化等多种病理改变,二者各有优势与不足,在脊索瘤临床诊断中的应用均有较高价值。

Analysis of Multi-slice Spiral CT and MRI Findings of Chordoma

Objective To summarize the multislice spiral CT and MRI findings of chordoma.Methods 34 patients with chordoma who were admitted in our hospital between January 2010 and March 2016 were selected as the study object. Spiral CT and MRI examination were performed and the multi-slice spiral CT and MRI findings were summarized.Results The predilection sites of patients with chordoma were skull base and sacrococcygeal region, irregular lobulated, elliptical or nodular. CT examination showed inhomogeneous low density shadow or low and equal density shadow, with clear boundary, osteolytic and expansive bone destruction, partially visible punctate or patchy calcification in chordoma. After enhanced scan, there were inhomogeneous and moderate enhancement. MRI plain scan showed that the tumors were smooth outline, clear edge, homogeneous or mixed low or equal signal on T1WI, obviously high signal or equal signal on T2WI,and equal or high signal on DWI. Ehanced scan showed particle-like light and moderate enhancement.Conclusion CT is good for the display of bone destruction and tumor calcification in chordoma. MRI has resolution to high soft tissues, which can display lesions with cystic degeneration, hemorrhage, calcification and other pathological changes. Each of them has its advantages and disadvantages. Both of them are of relatively higher value in the clinical diagnosis of chordoma.