| 史东宏,曹建民,王中秋,许健,孔伟东,卢光明.脊髓室管膜肿瘤的MRI与病理的对照研究[J].中国医学影像技术,2008,24(5):645~649 |
| 脊髓室管膜肿瘤的MRI与病理的对照研究 |
| A comparative study of pathology with the manifestation of MRI in spinal cord ependymal neoplasms |
| 投稿时间：2007-12-13 修订日期：2008-03-04 |
| DOI： |
| 中文关键词: 室管膜肿瘤 病理 手术 磁共振成像 |
| 英文关键词:Ependymal neoplasms Pathology Operation Magnetic resonance imaging |
| 基金项目:本课题受江苏省"六大人才高峰"项目(2005A2)资助。 |
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| 中文摘要: |
| 目的 探讨脊髓室管膜肿瘤的MRI表现与病理之间的关系,以提高对本病的认识。 方法 回顾性分析44例脊髓室管膜肿瘤的MRI表现、病理资料、手术所见及随访资料。 结果 室管膜瘤(WHOⅡ级,24例);间变型室管膜瘤(WHOⅢ级,10例);黏液乳头型室管膜瘤(WHOⅠ级,8例);含室管膜瘤的混合型胶质瘤(WHOⅡ级,2例)。MRI表现为:颈段19例;胸段6例;腰骶段19例。84.1%(37/44)肿瘤边界清楚;T1WI以等或低信号为主;T2WI以高或混杂信号为主。86.4%(38/44)肿瘤强化明显,77.3%(34/44)肿瘤不均匀强化;43.2%(19/44)肿瘤两端可见囊腔。术中72.7%(32/44)肿瘤境界清楚,90.9%(40/44)无包膜。经统计学分析表明病理分型、分级与发病部位相关(P＜0.05);手术残留与术中所见边界、MRI边界相关(P＜0.05);MRI边界与术中所见边界无统计学差异(P＞0.05)。 结论 脊髓室管膜肿瘤的MRI具有较特征性表现,能较好地显示肿瘤的内部结构、明确肿瘤范围,有助于该病的鉴别诊断、指导制定治疗方案和评价治疗效果。 |
| 英文摘要: |
| Objective To explore the correlation between the manifestation of MRI and pathology, and to improve the knowledge in spinal cord ependymal neoplasms. Methods The MRI manifestation, pathology, operational records and follow-up data were analyzed retrospectively in 44 cases with spinal cord ependymal neoplasms. Results Among 44 cases of spinal cord ependymal neoplasms, 24 were ependymoma (WHO gradeⅡ); 10 anaplastic ependymomas (WHO grade Ⅲ) and 8 mucinous papillary ependymomas (WHO gradeⅠ); 2 mixed type glioma with ependymas (WHO grade Ⅱ). There were 19 lesions in the cervical, 6 in the thoracic, and 19 in the lumbar and sacral segments in MRI. Clear tumor margins were seen in 84.1% (37/44) of all patients; on T1-weighted MRI, most were isointensive or hypointensive signals. Most tumors were hyperintense or confounding on T2-weighted MRI. 86.4% (38/44) enchanced markedly; 77.3% (34/44) were heterogeneous enchancement. Rostral and caudal cysts were seen in 43.2% (19/44) of all patients. Well-defined margins, though 90.9% (40/44) of all patients lacking true tumor envelopes, were seen in 72.7% (32/44) of the operational findings. Statistical analysis indicated that pathology types and grades in spinal cord ependymal neoplasms were correlated with lesion positions (P＜0.05), operational residua with tumor margins in operation or MRI, without correlation with pathologial types and grades (P＜0.05). No significant statistical difference was found in tumor margins between operation and MRI. Conclusion The spinal cord ependymal neoplasms show characteristic manifestations on MRI. MRI can show the intra-tumor structures and the extent of the tumor very well, which is helpful in differential diagnosis, respectability prediction metastases detection and eveluation of the response to treatment. |
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