胸椎管内神经中轴钙化性假瘤的诊断与治疗

摘要

Objective To explore the characteristics of calcifying pseudoneoplasm of the neuraxis ( CAPNON) , and to improve the di-agnostic level and standard of treatment. Methods The clinical traits, imaging features and curative effect of one case of CAPNON who were treated in our departmen were analyzed combined with the pathological analysis and literature review. Results Transient back pain was the only clinical presentation of the patient. CT images showed obvious calcification. MRI showed low signal in T1-weigthed images and T2-weighted images. Examined with the contrast-enhanced MR images, the lesion showed inhomogeneous enhancement. No nervous symptom newly occurred in the 6-month follow-up. Conclusion Symptoms of patients with CAPNON are generally related to local compression or irri-tation of the adjacent tissue. CAPNON should be highly suspected in patients with dense calcification in the CT combined with low signal in T1-weigthed images and T2-weighted images and rim or internal inhomogeneous linear enhancement in the MRI. The final diagnosis depends on the histopathological analysis, and surgical resection is the major therapy.%目的 探讨神经中轴钙化性假瘤( CAPNON)的病例特点,以提高对该病的诊断水平,规范治疗方法. 方法 回顾性分析我科收治的1例胸椎管内神经中轴钙化性假瘤临床资料,结合病理分析及文献回顾,分析CAPNON的临床特点、影像学特点及外科治疗效果. 结果 该例CAPNON患者表现为一过性背部疼痛,影像学表现为CT高密度影,MRI低T1低T2信号,伴不均匀强化;接受神经外科治疗切除病灶后,随访6个月,恢复良好,无新发神经症状.结论 CAPNON临床表现为局部脑、脊髓、神经或血管受压引起的相应症状,CT检查为局限性钙化灶,MRI表现为低T1低T2信号,增强扫描可见不均匀强化或病灶边缘线性强化;最终诊断应依靠病理,治疗以手术切除病灶为主.