肿瘤占位率——一种预测良性硬脊膜内髓外脊髓肿瘤手术结果的影像学特征
Tumor Occupancy Ratio-An Imaging Characteristic Prognosticating the Surgical Outcome of Benign Intradural Extramedullary Spinal Cord Tumors.
作者信息
Singh Prashant Raj, Pandey Tarun Kumar, Sharma Raghavendra Kumar, Ahmad Faran, Kumar Ankur, Agarwal Abhay
机构信息
Department of Neurosurgery, All India Institute of Medical Sciences, Raipur, India.
Department of Neurosurgery, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, India.
出版信息
Int J Spine Surg. 2021 Jun;15(3):570-576. doi: 10.14444/8077. Epub 2021 May 7.
BACKGROUND
Intradural extramedullary (IDEM) spinal cord tumors are two thirds of all spinal tumors. We have prospectively analyzed the importance of the tumor occupancy ratio as a factor for predicting the course of the disease and in prognosticating the surgical outcome in patients with IDEM tumors.
METHODS
We prospectively analyzed 44 consecutive cases of IDEM tumors, diagnosed as cervical, thoracic, and lumbar IDEM tumors (excluding conus/cauda equina lesion) by magnetic resonance imaging (MRI), that were operated on at our institution between 2014 and 2016. We measured the tumor occupancy ratio and noted the sagittal and axial location of the tumor in the preoperative MRI and performed the laminectomy and unilateral medial facetectomy. A primary outcome has been noted according to the gait disability score in the preoperative period and in the follow-up period of 1 year. In the statistical analysis, categorical variables were compared using a chi-square test, and an analysis of variance and student tests were used for the continuous variables. < .05 was considered statistically significant.
RESULTS
The tumor occupancy ratio showed a significant association to the preoperative gait disability score ( < .001) and also predicted that the surgical outcome is much better in patients with tumors with a low tumor occupancy ratio than in patients with tumors with a high occupancy ratio ( < .001). No difference in the tumor occupancy ratio was noted in 2 different pathological tumors, and there was also no difference in the tumor occupancy ratio at different sagittal and axial locations of the tumor.
CONCLUSION
Tumor occupancy ratio has shown a significant impact on the preoperative course and also predicts the surgical outcome in patients with IDEM tumors. Hence, it is an important imaging characteristic to prognosticate the outcome in IDEM tumors and should be noted in each case.
背景
硬脊膜内髓外（IDEM）脊髓肿瘤占所有脊髓肿瘤的三分之二。我们前瞻性地分析了肿瘤占位率作为预测疾病进程和IDEM肿瘤患者手术结果的一个因素的重要性。
方法
我们前瞻性地分析了44例连续的IDEM肿瘤病例，这些病例经磁共振成像（MRI）诊断为颈、胸和腰段IDEM肿瘤（不包括圆锥/马尾病变），于2014年至2016年在我们机构接受手术。我们测量了肿瘤占位率，并在术前MRI上记录肿瘤的矢状位和轴位位置，然后进行椎板切除术和单侧内侧关节突切除术。根据术前和1年随访期的步态残疾评分记录主要结果。在统计分析中，分类变量使用卡方检验进行比较，连续变量使用方差分析和学生检验。P < 0.05被认为具有统计学意义。
结果
肿瘤占位率与术前步态残疾评分显著相关（P < 0.001），并且还预测肿瘤占位率低的患者手术结果比占位率高的患者好得多（P < 0.001）。在两种不同病理类型的肿瘤中，肿瘤占位率没有差异，在肿瘤不同的矢状位和轴位位置，肿瘤占位率也没有差异。
结论
肿瘤占位率对术前病程有显著影响，并且还可预测IDEM肿瘤患者的手术结果。因此，它是预测IDEM肿瘤预后的一个重要影像学特征，在每个病例中都应予以关注。
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