Van Goethem J W M, van den Hauwe L, Ozsarlak O, De Schepper A M A, Parizel P M
Department of Radiology, Universitair Ziekenhuis Antwerpen, Antwerp 2650, Belgium.
Eur J Radiol. 2004 May;50(2):159-76. doi: 10.1016/j.ejrad.2003.10.021.
Spinal tumors are uncommon lesions but may cause significant morbidity in terms of limb dysfunction. In establishing the differential diagnosis for a spinal lesion, location is the most important feature, but the clinical presentation and the patient's age and gender are also important. Magnetic resonance (MR) imaging plays a central role in the imaging of spinal tumors, easily allowing tumors to be classified as extradural, intradural-extramedullary or intramedullary, which is very useful in tumor characterization. In the evaluation of lesions of the osseous spine both computed tomography (CT) and MR are important. We describe the most common spinal tumors in detail. In general, extradural lesions are the most common with metastasis being the most frequent. Intradural tumors are rare, and the majority is extramedullary, with meningiomas and nerve sheath tumors being the most frequent. Intramedullary tumors are uncommon spinal tumors. Astrocytomas and ependymomas comprise the majority of the intramedullary tumors. The most important tumors are documented with appropriate high quality CT or MR images and the characteristics of these tumors are also summarized in a comprehensive table. Finally we illustrate the use of the new World Health Organization (WHO) classification of neoplasms affecting the central nervous system.
脊柱肿瘤是罕见的病变,但就肢体功能障碍而言,可能会导致严重的发病率。在对脊柱病变进行鉴别诊断时,病变位置是最重要的特征,但临床表现以及患者的年龄和性别也很重要。磁共振(MR)成像在脊柱肿瘤成像中起着核心作用,能够轻松地将肿瘤分类为硬膜外、硬膜内-髓外或髓内肿瘤,这对肿瘤特征的判定非常有用。在评估脊柱骨病变时,计算机断层扫描(CT)和MR都很重要。我们将详细描述最常见的脊柱肿瘤。一般来说,硬膜外病变最为常见,其中转移瘤最为频发。硬膜内肿瘤较为罕见,大多数为髓外肿瘤,其中脑膜瘤和神经鞘瘤最为常见。髓内肿瘤是不常见的脊柱肿瘤。星形细胞瘤和室管膜瘤占髓内肿瘤的大部分。通过高质量的CT或MR图像记录最重要的肿瘤,并在综合表格中总结这些肿瘤的特征。最后,我们阐述了世界卫生组织(WHO)对影响中枢神经系统肿瘤的新分类的应用。