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1、脊柱病变的影像学诊断1CT脊柱检查2CT脊柱检查3MRI检查脊柱的优势总体优势：多参数成像多方位成像，尤其矢状断层独特优势：目前唯一能直接显示脊髓内部的影像检查方法4椎间盘病变椎间盘及椎体的退变椎间盘膨出和脱出从脊柱长轴全面观察以免漏掉其他病变观察突出椎间盘对脊髓或神经根的压迫程度5DEGENERATION椎间盘变性：SET2GRET2*T1WI椎体终板信号改变：6DEGENERATION7NormalPost-radiotherapy8DISC-HERNIATION9DISC-HERNIATION10DISC-HER
2、NIATION11DISC-HERNIATION12DISC-HERNIATION13DISC-HERNIATION14椎管狭窄分型：中心型外围型先天型后天型15颈椎病16DISC-HERNIATION17BASALDEPRESSION18SPINALCANALSTENOSIS19OPLL20脊柱创伤观察脊髓的受伤程度：水肿、肿胀、出血、断裂、软化观察椎体的状况：有形态改变的骨折无明显形态改变的小梁骨折观察椎管的其他改变：增生、狭窄21脱位:位置错位3.5cm成角11度22TRAUMA23TRAUMA脊髓震荡脊髓受压脊
3、髓挫伤24脊髓损伤三型:1挫伤伴出血2水肿3混合25TRAUMA26TRAUMA27TRAUMA28椎管肿瘤髓内肿瘤髓外硬膜下肿瘤硬膜外肿瘤29髓内肿瘤IntramedullarySpinalNeoplasms30Ependymoma(室管膜瘤)Themostcommonintramedullaryspinalneoplasminadults,60%,38.8,maleCervicalcordalonetheupperthoracicregion.MyxopapillaryependymomaDurationofsym
4、ptomswas36.5monthsBackorneckpain(67%),sensorydeficits(52%),motorweakness(46%),31ImagingCharacteristicsCTX-ray:scoliosisorcanalwideningwithassociatedvertebralbodyscalloping,pedicleerosion,orlaminarthinningMRI:T1WIiso-orhypointense;T2WIhyperintensethe"capsign,"ari
5、mofextremehypointensity(seenatthepolesofthetumoronT2WI.cordedema.3.6vertebralsegments;Cystsareacommon,SyringohydromyeliaWellcontrast-enhanced32室管膜瘤髓内肿瘤333435室管膜瘤36室管膜瘤37Astrocytoma(星形细胞瘤)One-thirdofallspinalcordgliomas；Male；29years；thoraciccord(67%),cervicalcord
6、(49%)；Involvementoftheentirespinalcord；rarefilumterminale；rarelyexophytic.Painandsensorydeficits；Motordysfunction.Youngchildren,withamediandurationof5months.38PathologicCharacteristicsIll-defineddiffusefusiformenlargement.Tumorcysts(eccentric,smaller,andirregula
7、r)andsyrinxesarecommonHypercellularityandtheabsenceofasurroundingcapsuleEnlarged,irregularlyshaped,hyperchromaticnuclei39WHOclassificationGradeI：pilocyticastrocytomas75%GradeII：fibrillarytypeGradeIII：anaplasticastrocytomas25%GradeIV：glioblastomamultiformedistinc
8、tlyuncommon40GradeIIGradeIV41ImagingCharacteristicsCT、X-ray：mildscoliosis,widenedinterpediculardistance,andboneerosionMRI：poorlydefinedmargins；T1WIiso-tohypointense；T
