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脊髓神经鞘瘤:CT成像的局限性

Spinal schwannoma: Limitations of CT imaging.

作者信息

Ibdah Mohammad G, Baraghithi Nora I, Al-Karaja Layth, Awida Hala, Abosleem Abdelrahman, Alwan Nafe' Abu, Salman Muayad, Nasser Qusai

机构信息

Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.

Radiology Department, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine.

出版信息

Radiol Case Rep. 2024 Sep 20;19(12):6068-6071. doi: 10.1016/j.radcr.2024.08.122. eCollection 2024 Dec.

Abstract

Spinal schwannomas are benign lesions that most commonly appear in the lumbar and thoracic regions of the spine. Although computed tomography (CT) scans are often used to assess spinal conditions, they are ineffective at detecting soft tissue abnormalities. This case is for a 49-year-old female who experienced a gradual loss of sensation and strength in her lower extremities, along with increased urinary urgency, over six weeks. In addition, mid-back pain has been present for one year. Initially, a CT scan was done and did not show any significant findings, which suggested the absence of a spinal abnormality. However, magnetic resonance imaging (MRI) revealed an intradural extramedullary lesion causing spinal cord compression. The patient successfully underwent surgery to remove the tumor, and histological analysis confirmed it as spinal schwannoma. This case underlines the diagnostic limitations of CT imaging for spinal lesions and illustrates the superior accuracy of MRI. Thus, a negative CT should not halt further diagnostic evaluation when symptoms persist.

摘要

脊髓神经鞘瘤是一种良性病变,最常见于脊柱的腰段和胸段。虽然计算机断层扫描(CT)常用于评估脊柱状况,但在检测软组织异常方面效果不佳。该病例为一名49岁女性,她在六周内逐渐出现下肢感觉和力量丧失,以及尿急加重的症状。此外,中背部疼痛已持续一年。最初进行了CT扫描,未发现任何明显异常,提示不存在脊柱病变。然而,磁共振成像(MRI)显示硬膜内髓外病变导致脊髓受压。患者成功接受了肿瘤切除手术,组织学分析证实为脊髓神经鞘瘤。该病例强调了CT成像对脊柱病变的诊断局限性,并说明了MRI具有更高的准确性。因此,当症状持续存在时,CT检查结果为阴性不应停止进一步的诊断评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a87/11458935/a99c594651d2/gr1.jpg

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