脊索瘤CTMRI影像学诊断及鉴别诊断.doc

脊索瘤CT\MRI影像学诊断及鉴别诊断 摘要：目的 旨在提高脊索瘤的ct、mr的影像学诊断和鉴别诊断水平及提高术前正确诊断率，为临床提供可靠的诊断依据。方法 对本院2000～2010年经临床手术病理证实的40例脊索瘤的ct及mri表现进行回顾性分析对比研究。结果 40例中肿瘤位于颅底者22例，颈2椎体者1例，腰3～4椎体者1例，骶尾部16例。其中26例行ct检查，14例行mri检查。结论ct对肿瘤钙化及周围骨质破坏明显优于mri，而mri对周围软组织浸润较ct为佳。两者结合可以提高肿瘤的正确诊断率及诊断水平，为临床提供可靠的诊断依据。 关键词：脊索瘤 体层摄影术 x线计算机 磁共振成像 ct the ct. mri imaging diagnosis of chordoma and the diagnosis of its identification yangjian1，que qi-ke2，dong qi-long1 1.department of medical imaging, fuzhou general hospital of nanjing military region 2.coalmine central hospital of fujian province [abstract] objective: to improve the imaging diagnosis of chordoma and the diagnosis of its identification . to enhance the correct rate of diagnosis before operation. by doing so, we can provide reliable diagnostic evidence for clinic. methods: the date from 40 patients with chordoma proved in our hospital from 2000 to 2010 were retrospectively analyzed and comparative studied. results: there are 22 patients whose tumors were lied in their skull bases, 1 in cervical, 1 in lumber vertebrae and 16 in sacrococcygeal. of all these patients, 26 of them accept ct scan and 14 of them accept mri scan. conclusion: ct is much better than mri in finding tumor calcification and bone destruction. however, mri is better than ct in scaning the infiltration of parenchyma. so the combination of ct and mri can improve the correct rate of diagnosis ot tumor and improve the diagnosis. besides, they can also provise reliable diagnostic evidence for clinic. [keywords] chordoma tomographyx-ray computed; magnetic resonance imaging ct 1 资料与方法 对本院2000～2010年经临床手术病理证实的40例脊索瘤的ct及mri表现进行回顾性分析对比研究。40例颅底脊索瘤中男27例，年龄21～63 岁，平均37岁；女13例，年龄19～69 岁，平均48岁。其中ct检查26例，mri检查14例。ct设备为philips brilliance64 层螺旋ct扫描仪，扫描参数：140kv，340ma， 螺距1.0，层厚５ｍｍ。增强扫描选用非离子型造影剂优维显（ulravist），1.5ml／kg，3.5～4ml／ｓ经肘静脉高压注射5s后增强扫描。mr检查使用机型为 eiscintgyrex2. 02sgr 型超导磁共振装置 ,ge公司1.5tmri超导成像系统，扫描时间为1.0s，增强扫描选用gd-dtpa，平扫后用高压注射器注入对比剂3s 后开始扫描，对比剂用量 1.2～1.3ml/kg ,流速5.0ml/s，延迟5.0s。视野320×400mm，矩阵512×512。 2 结果