Wein Sara, Gaillard Francesco
Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Postgrad Med J. 2013 Aug;89(1054):457-69. doi: 10.1136/postgradmedj-2012-131503. Epub 2013 Jun 7.
Intradural spinal tumours, although relatively uncommon, can be diagnostically challenging, and often result in significant morbidity. They can be subdivided according to their cell of origin and whether they are within the cord (intramedullary) or intradural but extramedullary in location. The differential diagnosis for masses of the cauda equina region is often considered separately. Additionally, some inflammatory processes, cysts, benign tumour-like masses and vascular malformations may mimic intradural tumours. Although in many instances, a precise preoperative diagnosis is not possible as many of the imaging findings overlap, some features may strongly suggest one diagnosis over others. This article reviews the range of intradural spinal tumours in the adult and paediatric populations, with an emphasis on pertinent imaging characteristics. An approach is provided for distinguishing tumours from lesions that mimic tumours and for narrowing the differential diagnosis according to imaging findings.
硬脊膜内脊髓肿瘤虽然相对少见，但在诊断上具有挑战性，且常导致严重的发病率。它们可根据起源细胞以及位于脊髓内（髓内）还是硬脊膜内但髓外的位置进行细分。马尾区肿块的鉴别诊断通常单独考虑。此外，一些炎症过程、囊肿、良性肿瘤样肿块和血管畸形可能会模仿硬脊膜内肿瘤。尽管在许多情况下，由于许多影像学表现重叠，无法进行精确的术前诊断，但某些特征可能强烈提示一种诊断而非其他诊断。本文回顾了成人和儿童人群中硬脊膜内脊髓肿瘤的范围，重点关注相关的影像学特征。提供了一种方法，用于区分肿瘤与模仿肿瘤的病变，并根据影像学表现缩小鉴别诊断范围。
