论文部分内容阅读
目的探讨多层螺旋CT(multi-slice spiral CT,MSCT)的多平面重建技术(multi-planar reconstruction,MPR)在脊柱旁神经鞘瘤的诊断与鉴别诊断的临床价值。方法回顾性分析22例脊柱旁神经鞘瘤的临床、影像资料,对比各例的多层螺旋CT横轴位及其MPR表现。结果 22例中15例位于胸段脊柱旁,7例位于腰段脊柱旁;8例跨越椎管内、外,伴相应椎间孔扩大;14例位于椎管外、脊柱旁。CT平扫显示5例较小肿块的密度大致均匀,增强扫描较均匀强化;17例较大肿块的密度不均匀,内有囊状更低密度灶;5例有斑点钙化影,增强扫描均呈不均匀强化。单纯CT横轴位图像对8例跨越椎管内、外的肿瘤定位准确,其余14例椎管外的肿瘤定位较困难,易与周围病变混淆。MPR明确显示肿块与神经根相连、受压及周围结构的关系,22例肿瘤全部定位正确。结论多层螺旋CT的MPR技术对椎管外神经鞘瘤的定位有独特优势,结合肿瘤的密度特点,对脊柱旁神经鞘瘤的诊断及鉴别诊断有重要意义。
Objective To investigate the clinical value of multi-planar reconstruction (MPR) of multi-slice spiral CT (MSCT) in the diagnosis and differential diagnosis of paraspinal schwannoma. Methods The clinical data and imaging data of 22 cases of paraspinal schwannoma were retrospectively analyzed. The transverse axial multislice CT and MPR were compared among the cases. Results Of the 22 cases, 15 cases were located beside the thoracic spine, 7 cases were located beside the lumbar spine, 8 cases spanned the medial and lateral spinal canal, and the corresponding intervertebral foramen enlarged. 14 cases were located outside the spinal canal and the spine. The CT scan showed that the density of the 5 cases was almost uniform and the contrast enhancement was enhanced. The density of the 17 cases was uneven and there were cystic lower densities. In 5 cases, speckled calcification and enhanced scan showed Unevenly enhanced. Simple CT horizontal axis images of 8 cases across the spinal canal, accurate positioning of the tumor, the remaining 14 cases of spinal canal tumor location more difficult and easily confused with the surrounding lesions. MPR clearly shows lumps and nerve roots connected to the pressure and the relationship between the surrounding structure, all 22 tumors positioned correctly. Conclusions Multi-slice spiral CT (MPR) has unique advantages for the location of spinal canal schwannoma. Combined with the density characteristics of the tumor, it is of great significance for the diagnosis and differential diagnosis of paraspinal schwannoma.