脊柱肿瘤ppt课件

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
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脱位: 位置错 位
3.5cm 成角 11度
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TRAU. MA
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TRAUM
A 脊髓震荡 脊髓受压 脊髓挫伤
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脊髓损伤
三型: 1 挫伤 伴出血 2 水肿 3 混合
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DEGENERATION
椎间盘变性： SET2 GRE T2* T1WI 椎体终板信 号改变：
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DEGENERATION
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Normal
Post-radiotherapy
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DISC-HERNIATION
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DISC-HERNIATION
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DISC-HERNIATION
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DISC-HE.RNIATION
Ependymoma
Astrocytoma
Population in which lesions most commonly occur Location in the spinal canal
• Back or neck pain (67%), sensory
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Imaging Characteristics
• CT X-ray: scoliosis or canal widening with
associated vertebral body scalloping, pedicle erosion, or laminar thinning
hyperchromatic nuclei
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WHO classification
• Grade I： pilocytic astrocytomas 75% • Grade II ：fibrillary type • Grade III ：anaplastic astrocytomas
25%
• Grade IV ：glioblastoma multiforme
T1WI iso- to hypointense ； T2WI hyperintense；seven vertebral segments； Cysts；eccentric； some enhancement
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髓内肿瘤
星形细胞瘤
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星形细胞瘤
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星形细胞瘤
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星形细胞瘤
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Characteristic
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DISC-HERNIATION
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DISC-HERNIATION
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椎管狭窄
分型： 中心型 外围型 先天型 后天型
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颈 椎 病
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DISC-HERNIATION 17
BASAL DEPRESSION
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SPINAL CAN. AL STENOSIS
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OPLL
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ቤተ መጻሕፍቲ ባይዱ
spinal neoplasm in adults, 60% ,
38.8 , male
• Cervical cord alone the upper
thoracic region.
• Myxopapillary ependymoma
• Duration of symptoms was 36.5
months
脊柱病变的影像学诊断
山东省医学影像学研究所
李传亭
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CT脊柱检查
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CT脊柱检查
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MRI检查脊柱的优势
• 总体优势：
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多参数成像
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多方位成像，尤其矢状断层
• 独特优势：
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目前唯一能直接显示脊髓内部的影像
检查方法
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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
exophytic.
• Pain and sensory deficits ；Motor
dysfunction.
• Young children, with a median duration of
5 months.
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Pathologic Characteristics
• Ill-defined diffuse fusiform
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TRAUMA
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TRAUMA
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TRAUMA
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椎管肿瘤
• 髓内肿瘤 • 髓外硬膜下肿瘤 • 硬膜外肿瘤
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髓内肿瘤
Intramedullary Spinal Neoplasms
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Ependymoma(室管膜瘤)
• The most common intramedullary
distinctly uncommon
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Grade II
Grade IV
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Imaging Characteristics
• CT 、X-ray：mild scoliosis, widened
interpedicular distance, and bone erosion
• MRI：poorly defined margins ；
enlargement.
• Tumor cysts (eccentric, smaller, and
irregular) and syrinxes are common
• Hypercellularity and the absence of a
surrounding capsule
• Enlarged, irregularly shaped,
Well contrast-enhanced
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髓内肿瘤
室管膜瘤
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室 管 膜 瘤
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室管膜瘤
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Astrocytoma (星形细胞瘤)
• One-third of all spinal cord gliomas； Male；
29 years；thoracic cord (67% ), cervical cord (49%) ；Involvement of the entire spinal cord；rare filum terminale ；rarely
• MRI: T1WI iso- or hypointense; T2WI
hyperintense the "cap sign," a rim of extreme hypointensity (seen at the poles of the tumor on T2WI.
cord edema. 3.6 vertebral segments; Cysts are a common , Syringohydromyelia