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1、MSCTMPR技术在脊柱旁神经鞘瘤诊断价值【摘要】目的探讨多层螺旋CT(multi-slicespiralCT,MSCT)的多平面重建技术(multi-planarreconstruction,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
2、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。【关键词】多层螺旋CT;多平面重建技术;神经鞘瘤;诊断TheValueofMulti-sliceSpiralCTMPRTechnologyinDiagnosisofNeurilemmomaBesidethe12SpineLVYong
3、-ge,TANYong-liang,HOUYu,etal.DepartmentofRadiology,AffiliatedHospitalofGuangzhouMedicalUniversity,Shajing518104,China【Abstract】ObjectiveToevaluatetheclincalvalueofmulti-planarreconstruction(MPR)andmulti-slicespiralCT(MSCT)indiagnosisanddifferentialdiagnosisofneurilemmomabesidethespine.Me
4、thodsTheclinicalandimagingdatasin22casesofneurilemmomawereanalyzed,axialMSCTandMPRimageswerecompared.Results22casesinthoracicspinesection15cases,7casesofvertebrallocatednear,8casesofinsideandoutside,spanningvertebrawithcorrespondingbetweenvertebraholeexpansion,14casesinthespinevertebra,b
5、eside.CTflatdisplay5casesandsmallmassdensityroughlyuniform,enhancethescanningeveneraggrandizement,17casesoflargemassdensity,unevencysticlowerdensitystove,5casesofcalcificationspots,therearescanning.SimplyCTimagestoa8distrbutionacrossvertebrainsideandoutsideofthetumoraccurate12positioning
6、andtherestofthespinalcanal14casesoftumorlocationisdifficult,easyandsurroundinglesionsconfusion.MPRclearlyshowwithnerverootandmasspressureandsurroundingstructures,andallthecorrectorientationtumor.ConclusionMPRtechnologywithMSCThasdistinctascendancyinthelocalization,combinedwithdensitychar
7、acteristicsoftumors,ithasimportantsignificanceindiagnosisanddifferentialdiagnosisofneurilemmomabesidespine.【Keywords】Multi-slicespiralCT;Multi-planarreconstruction;Neurilemmoma;Diagnosis作者单位:518104广州医学院附属深圳沙井医院放射科12神经鞘瘤是神经源性肿瘤最多见的类型,而颈部间隙、胸部后纵隔及腰椎脊柱旁又是全身神经源肿瘤最好发的部位。术前进行准确