脊柱肿瘤培训课件.pptVIP

SUBDURAL CYST * * * 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 distinctly uncommon * Grade II Grade IV * Imaging Characteristics CT 、X-ray：mild scoliosis, widened interpedicular distance, and bone erosion MRI：poorly defined margins ；T1WI iso- to hypointense ； T2WI hyperintense；seven vertebral segments； Cysts；eccentric； some enhancement * 星形细胞瘤 髓内肿瘤 * 星形细胞瘤 * 星形细胞瘤 * 星形细胞瘤 * Characteristic Ependymoma Astrocytoma Population in which lesions most commonly occur Adult Pediatric Location in the spinal canal Central Eccentric Morphologic appearance Well circumscribed Ill defined Hemorrhage Common Uncommon Enhancement with contrast material Focal,intense homogeneous Patchy, irregular Predilection for involvement of the conus medullaris or filum terminale Yes No * Hemangioblastoma 血管母细胞瘤 Thoracic cord (50%), solitary ,younger than 40 ys . Highly vascular, discrete, nodular, red-to-orange masses abutting the leptomeninges with prominent dilated and tortuous vessels on the posterior cord surface . Syrinx is common * Imaging Characteristics CT : hypoattenuated cystlike mass MRI: diffuse cord expansion and variable signal intensity on T1WI, isointense (