脊柱肿瘤 PPT课件
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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
21
脱位: 位置错 位 3.5cm 成角 11度
22
TRAUMA
23
TRAUM A 脊髓震荡 脊髓受压 脊髓挫伤
24
脊髓损伤
三型: 1 挫伤 伴出血 2 水肿 3 混合
25
TRAUMA
26
TRAUMA
12
DISC-HERNIATION
13
DISC-HERNIATION 14
椎管狭窄
分型： 中心型 外围型 先天型 后天型
15
颈 椎 病
16
DISC-HERNIATIO17N
BASAL DEPRESSION
18
SPINAL CANAL STENOSIS
19
OPLL 20
脊柱创伤
观察脊髓的受伤程度： 水肿、肿胀、出血、断裂、软化
irregular) and syrinxes are common Hypercellularity and the absence of a
surrounding capsule Enlarged, irregularly shaped,
hyperchromatic nuclei
39
WHO classification
5
DEGENERATION
椎间盘变性： SET2 GRE T2* T1WI 椎体终板信 号改变：
6
DEGENERATION
7
Normal
Post-radiotherapy 8
DISC-HERNIATION
9
DISC-HERNIATION
10
DISC-HERNIATION
11
DISC-HERNIATION
脊柱病变的影像学诊断
.
1
CT脊柱检查
2
CT脊柱检查
3
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
4
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
31
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
32
髓内肿瘤
室管膜瘤
33
34
35
室 管 膜 瘤
36
室管膜瘤
37
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.
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%),
Grade I： pilocytic astrocytomas 75% Grade II ：fibrillary type Grade III ：anaplastic astrocytomas 25% Grade IV ：glioblastoma multiforme
distinctly uncommon
40
Grade II
Grade IV
41
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
27
TRAUMA
28
椎管肿瘤
髓内肿瘤 髓外硬膜下肿瘤 硬膜外肿瘤
29
髓内肿瘤
Intramedullary Spinal Neoplasms
30
Ependymoma(室管膜瘤)
The most commowenku.baidu.com intramedullary spinal neoplasm in adults, 60% , 38.8 , male
42
髓内肿瘤
星形细胞瘤 43
星形细胞瘤
44
星形细胞瘤 45
星形细胞瘤
46
Characteristic
Ependymoma
Astrocytoma
Population in which lesions most commonly occur Location in the spinal canal
Pain and sensory deficits ；Motor dysfunction. Young children, with a median duration of 5
months.
38
Pathologic Characteristics
Ill-defined diffuse fusiform enlargement. Tumor cysts (eccentric, smaller, and
观察椎管的其他改变： 增生、狭窄
21
脱位: 位置错 位 3.5cm 成角 11度
22
TRAUMA
23
TRAUM A 脊髓震荡 脊髓受压 脊髓挫伤
24
脊髓损伤
三型: 1 挫伤 伴出血 2 水肿 3 混合
25
TRAUMA
26
TRAUMA
12
DISC-HERNIATION
13
DISC-HERNIATION 14
椎管狭窄
分型： 中心型 外围型 先天型 后天型
15
颈 椎 病
16
DISC-HERNIATIO17N
BASAL DEPRESSION
18
SPINAL CANAL STENOSIS
19
OPLL 20
脊柱创伤
观察脊髓的受伤程度： 水肿、肿胀、出血、断裂、软化
irregular) and syrinxes are common Hypercellularity and the absence of a
surrounding capsule Enlarged, irregularly shaped,
hyperchromatic nuclei
39
WHO classification
5
DEGENERATION
椎间盘变性： SET2 GRE T2* T1WI 椎体终板信 号改变：
6
DEGENERATION
7
Normal
Post-radiotherapy 8
DISC-HERNIATION
9
DISC-HERNIATION
10
DISC-HERNIATION
11
DISC-HERNIATION
脊柱病变的影像学诊断
.
1
CT脊柱检查
2
CT脊柱检查
3
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
4
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
31
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
32
髓内肿瘤
室管膜瘤
33
34
35
室 管 膜 瘤
36
室管膜瘤
37
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.
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%),
Grade I： pilocytic astrocytomas 75% Grade II ：fibrillary type Grade III ：anaplastic astrocytomas 25% Grade IV ：glioblastoma multiforme
distinctly uncommon
40
Grade II
Grade IV
41
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
27
TRAUMA
28
椎管肿瘤
髓内肿瘤 髓外硬膜下肿瘤 硬膜外肿瘤
29
髓内肿瘤
Intramedullary Spinal Neoplasms
30
Ependymoma(室管膜瘤)
The most commowenku.baidu.com intramedullary spinal neoplasm in adults, 60% , 38.8 , male
42
髓内肿瘤
星形细胞瘤 43
星形细胞瘤
44
星形细胞瘤 45
星形细胞瘤
46
Characteristic
Ependymoma
Astrocytoma
Population in which lesions most commonly occur Location in the spinal canal
Pain and sensory deficits ；Motor dysfunction. Young children, with a median duration of 5
months.
38
Pathologic Characteristics
Ill-defined diffuse fusiform enlargement. Tumor cysts (eccentric, smaller, and