课件：脊柱肿瘤.ppt

TERATOMA 其他肿瘤 TERATOMA METASTASIS SUBDURAL CYST SACRUM CANAL CYST 硬膜外肿瘤 单纯硬膜外软组织肿瘤 椎体肿瘤 椎体并软组织肿瘤 METASTASIS METASTASIS-1 METASTASIS-2 脊索瘤 脊索瘤 METASTASIS METASTASIS METASTASIS ACIDOPHIL GRANULOMA MULTIPLE MYELOMA 脊柱先天畸形 脊髓脊椎的发育和解剖 神经管闭合不全 脊柱裂: 隐性;伴脊膜膨出;伴脊髓脊膜膨出 脊柱裂 脊髓栓系 脊膜膨出 脊髓纵裂 TETHERED CORD TETHERED CORD 脊髓空洞症 鉴别空洞的类型:先天性和继发性 空洞和积水 确认累及范围 SYRINGOMYELIA SYRINGOMYELIA SYRINGOMYELIA SYRINGOMYELIA (DIFFERENT TYPE) 复习题 1、急、慢性化脓性骨髓炎的发病过程和影像学表现。 2、脊柱结核的影像学表现。 3 、化脓性关节炎与滑膜型关节结核的鉴别诊断。 4 、类风湿性关节炎的影像学表现。 5、强直性脊柱炎的影像学表现 6 、退行性骨关节病的影像学表现特点。 7、脊髓内星形细胞瘤与室管膜瘤的鉴别诊断 谢谢 Ependymoma(室管膜瘤) The most common intramedullary spinal neoplasm in adults, 60% , 38.8 , male 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%), 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 室管膜瘤 髓内肿瘤 室管膜瘤 室管膜瘤 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. Pain and sensory deficits ；Motor dysfunction. Young children, with a median duration of 5 months. Pathologic Characteristics Ill-defined diffuse fusiform enlargement. Tumor cysts (eccentric, smaller, and irregular) and syrinxes are common Hypercellularity and the absence of a surrounding capsule Enlarged, irregularly shaped, hyperchromatic nuclei WHO classification Grade I： pilocytic astrocytomas 75% Grade II ：fibrillary type Grade III ：anaplastic astrocytomas 25% Grade IV ：glioblastoma multiforme