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目的 :提高低位脊神经鞘瘤诊治的准确率。方法 :对收治的曾被误诊为腰椎间盘突出症的腰骶部脊神经鞘瘤 14例患者的临床特征、影像学检查方法和结果、临床误诊误治经过等进行详细的总结和分析。结果 :(1)低位神经鞘瘤患者腰腿痛的特点与椎间盘突出症恰恰相反。 (2 )MRI对椎管内肿瘤检出率明显提高 ,对其定位、定性、了解预后均有决定性意义 ;临床怀疑椎管内病变时 ,不提倡使用CT。本组 10例作CT后漏诊。结论 :以临床特征为基础 ,正确使用特殊检查 (MRI)手段 ,可对脊神经鞘瘤做出正确诊断。
Objective: To improve the accuracy of diagnosing and treating low schwannoma. Methods: 14 cases of lumbosacral schwannoma who had been misdiagnosed as lumbar disc herniation were reviewed. The clinical features, imaging examination methods and results, clinical misdiagnosis and mistreatment were summarized and analyzed in detail. Results: (1) The characteristics of low back pain in patients with low schwannoma are opposite to those of disc herniation. (2) MRI detection rate of spinal tumors was significantly improved, its positioning, characterization, prognosis have decisive significance; clinical suspicion of spinal canal lesions, do not advocate the use of CT. The group of 10 cases after CT missed diagnosis. Conclusion: On the basis of clinical features, correct diagnosis of spinal schwannoma can be correctly used by special inspection (MRI).