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目的探讨颅底脊索瘤CT与MR影像学诊断与鉴别诊断。方法回顾性分析13例经病理证实的颅底脊索瘤的CT与MR影像学资料。结果13例脊索瘤中,发生在斜坡5例,鞍区4例,颅中凹2例,鼻咽部1例,蝶窦1例。肿瘤的形态以不规则形最多8例,圆形3例,椭圆形2例。病灶边界清楚9例,边缘模糊4例。MR表现为T1WI呈低、等、高混杂信号,T2WI则以高、低混杂信号为主。增强后病灶呈轻到中度强化,强化信号不均匀。CT见病灶呈不均匀等或稍高密度肿块,7例可见不同程度的骨质破坏。结论颅底脊索瘤的CT和MR表现有一定的特征性,结合临床大多可以确诊,但需与脑膜瘤、垂体瘤、鼻咽癌、软骨类肿瘤等鉴别。
Objective To investigate the CT and MR imaging diagnosis and differential diagnosis of skull base chordoma. Methods Retrospective analysis of 13 cases of pathologically confirmed skull base chordoma by CT and MR imaging data. Results Among the 13 cases of chordoma, there were 5 cases of ramps, 4 cases of saddle, 2 cases of cranial recess, 1 case of nasopharynx and 1 case of sphenoid sinus. Tumor morphology to irregular shape up to 8 cases, 3 cases of round, 2 cases of oval. Clear border of the clear nine cases, 4 cases of edge blur. MR showed T1WI was low, equal, high mixed signal, T2WI is high, low mixed signal based. After enhancement, the lesion showed mild to moderate enhancement and enhancement of signal unevenness. CT see lesions were uneven or slightly higher density mass, 7 cases showed varying degrees of bone destruction. Conclusion CT and MR manifestations of skull base chordoma have certain characteristics, most of which can be diagnosed with clinical practice, but need to be differentiated from meningiomas, pituitary tumors, nasopharyngeal carcinoma and cartilaginous tumors.