--脊柱肿瘤 ppt课件

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脱位: 位置错 位 3.5cm 成角 11度
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TRAUMA
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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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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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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 exophytic. Pain and sensory deficits ；Motor dysfunction. Young children, with a median duration of 5 months.
脊柱病变的影像学诊断
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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： 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

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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
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Pathologic Characteristics
Ill-defined diffuse fusiform enlargement. Tumor cysts (eccentric, smaller, and irregular) and syrinxes are common Hypercellularity and the absence of a surrounding capsule Enlarged, irregularly shaped, hyperchromatic nuclei
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Ependymoma(室管膜瘤)
The most common intramedullary spinal neoplasm in adults, 60% , 38.8 , male Cervical cord alone the upper thoracic region. Myxopapillary ependymoma Duration of symptoms was 36.5 months Back or neck pain (67%), sensory deficits (52%), motor weakness (46%),

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WHO classification

Grade I： pilocytic astrocytomas 75% Grade II ：fibrillary type Grade III ：anaplastic astrocytomas 25% Grade IV ：glioblastoma multiforme distinctly uncommon
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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-HERNIATION

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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
Ependymoma
Astrocytoma
Population in which lesions most commonly occur Location in the spinal canal
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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
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BASAL DEPRESSION
ຫໍສະໝຸດ Baidu
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SPINAL CANAL STENOSIS
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OPLL
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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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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 ；T1WI iso- to hypointense ； T2WI hyperintense；seven vertebral segments； Cysts；eccentric； some enhancement

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Imaging Characteristics


CT X-ray: scoliosis or canal widening with associated vertebral body scalloping, pedicle erosion, or laminar thinning 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 Well contrast-enhanced