骶尾椎脊索瘤的CT与MRI征象分析

摘要

目的 分析骶尾椎脊索瘤的CT和MRI征象,以提高诊断准确性.方法 回顾性分析30例经手术病理证实的骶尾椎脊索瘤的CT和MRI表现.30例均行CT、MRI检查,其中CT增强28例,MRI增强25例.结果 30例均见骶尾椎膨胀性不规则骨质破坏,偏心性1例,中心性29例,大部分肿瘤体积较大.CT:显示钙化29例,出血4例,"反引号"征10例.增强后不均匀强化26例,较均匀强化2例.MRI:T1 WI呈低信号为主混杂信号,T2 WI呈高信号为主混杂信号,出血26例,分隔25例,假包膜18例,坏死囊变6例,"反引号"征18例,"分节现象"15例.增强后"蜂房样"强化23例.30例中,臀部肌肉受累8例,骶髂关节受累4例.结论 CT和MRI能很好显示骶尾椎脊索瘤范围、骨质破坏程度、软组织肿块及邻近组织受侵情况,其表现有一定的特征性,对提高诊断准确性具有帮助.%Objective To analyze the CT and MRI features of the sacrococcygeal chordoma , so as to improve its diagnostic accuracy .Methods 30 cases of sacrococcygeal chordoma proved by pathology were examined with CT and MRI retrospectively . All of 30 cases underwent CT and MRI examinations , and 28 cases were examined by CT enhancement , 25 cases by MRI en-hancement.Results In 30 cases, all sacrococcygeal chordoma demonstrated expansibility and irregular bone destruction , among which eccentricity was 1 case, centrality was 29 cases, and most of the tumor presented with large size .CT demonstrated calcifi-cation in 29 cases, bleeding in 4 cases,"anti-quote" sign in 10 cases, uneven enhancement in 26 cases and uniform enhance-ment in 2 cases.On MR images, all lesions demonstrated mixed low signal intensity on T 1 WI and mixed high signal intensity on T2 WI.The lesions presented with bleeding in 26 cases, separation in 25 cases, pseudocapsule was found in 18 cases, cystic areas in 6 cases,"anti-quote" sign in 18 cases, segmentation in 15 cases and "honeycomb"reinforced in 23 cases.Hip muscle inva-sion in 8 cases, sacroiliac joint involvement in 4 cases.Conclusion The extension, the degree of bone destruction , the soft tis-sue mass and adjacent tissue involvement of the sacrococcygeal chordoma can be clearly delineated on CT and MRI .The charac-teristics of this disorder are very helpful to improve the diagnostic accuracy .