术前MRI诊断椎管内神经源性肿瘤50例分析

摘要

Objective:To study MRI features of intraspinal neurogenic tumors for improving the diagnosis accuracy and reducing misdiagnosis rate. Methods:Fifty patients with a preoperative diagnosis of neurogenic tumors through MRI were retrospectively reviewed and analyzed. All patients imaging findings were compared with the operative and pathological diagnosis. Results:Thirty-seven neurogenic tumors were diagnosed accurately(diagnostic accuracy, 74%), including schwannomas 35 cases and neurofibromas 2 cases. Thirteen cases were misdiagnosed(the rate of misdiagnosis, 26%), including spinal meningiomas 8 cases, hemangiomas 2 cases, metastatic tumor of pinealoma 1 case, plasma cell myeloma 1 case and lateral lumbar disc herniation 1case. Conclusion:MRI findings conbined with location and clinical history are helpful in improving preoperative diagnostic rate of intraspinal neurogenic tumors.%目的:探讨椎管内神经源性肿瘤的MRI征象,以提高其诊断准确率,减少误诊.方法:回顾分析50例术前MRI诊断为神经源性肿瘤的临床影像资料,与术后病理诊断进行对照.结果:37例经手术病理证实诊断正确,诊断正确率74%,其中神经鞘瘤35例,神经纤维瘤2例;13例术前将其他疾病误诊为神经源性肿瘤,误诊率为26%,其中脊膜瘤8例,血管瘤2例,松果体瘤椎管内转移、浆细胞骨髓瘤及极外侧型椎间盘突出各1例.结论:细致观察肿瘤的MRI征象,结合性别、发病部位及临床病史等进行综合分析,有助于提高神经源性肿瘤的术前MRI诊断和鉴别诊断水平.