脊柱肿瘤和肿瘤样病变课件.ppt

1、脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变T12脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变FigA:Radiograph reveals a subtle lucent area(arrow)in a right articular mass.FigB:CT scan shows the nidus(l

2、arge arrowheads)with a small central area of calcification(small arrowhead)and minimal surrounding sclerosis.FigC:Radiograph of the resected specimen shows that the nidus was entirely removed(arrows).FigD:Posterior bone scan shows intense uptake of the radionuclide by the nidus(arrow)17,yr,M Osteoid

3、 osteoma of lamina at T-11 脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变Fig.A L radiographFig.B CT脊柱肿瘤和肿瘤样病变Fig.D Sag.T2WIFig.C Axi.T1WI脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变Lateral x-ray films(a)showed a soft-tissue swelling in the retropharyngeal space.Lateral(b)and coro

4、nal(c)MR images demonstrating tumor in the C-2 body and a soft-tissue mass from C16.Axial CT scan(d)demonstrating a typical osteoid nidus with peritumoral sclerotic rim on the right side of the C-2 body.Technetium bone scan(e)also displays pronounced uptake in this region.We performed tumor excision

5、 via an anterolateral retropharyngeal approach(f)occipitocervical fixation by using two axis plates and titanium wires(g).Lateral x-ray films obtained immediately after(h)and 2 years postsurgery(i)showing solid fusion.10,yr,M osteoblastoma of C2 脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤

6、和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变Fig.ALateral radiograph shows destruction of the distal sacrum and coccyx with calcification(arrow).Fig.BCT scan also demonstrates the bone destruction and a soft-tissue mass(arrowheads)containing calcifications(ar

7、row).Chordoma of lower sacrum 48-year-old manFig.AFig.B脊索瘤脊柱肿瘤和肿瘤样病变Fig.C T1WI Sagittal and axial T2WI Fig.DMR images reveal the expansile sacrococcygeal lesion (arrowheads),which has high signal intensity on D.Fig.CFig.D脊索瘤脊索瘤脊柱肿瘤和肿瘤样病变Fig.E As seen in this sagittal section of the gross specimen,th

8、e MR imaging appearance correlates with the expansile lesion(arrowheads)and calcification(arrow).The upper sacrum(*)is spared脊索瘤脊柱肿瘤和肿瘤样病变Upper Left and Right:Axial CT scans demonstrating a large soft-tissue mass extending anteriorly to involve the rectum and posteriorly to invade the buttocks;calci

9、fication is seen within the mass.Lower Left and Right:Sagittal fast spin echo T2-weighted and axial T2-weighted MR images demonstrating the lesion infiltrating the presacral region,extending to surround the rectum and the perivesical fat but not invading the bladder.24-yr Mchordoma involving S3-5脊索瘤

10、脊柱肿瘤和肿瘤样病变chordomaFig.AFig.B脊索瘤脊索瘤脊柱肿瘤和肿瘤样病变残存椎间盘形成的“分节”现象脊柱肿瘤和肿瘤样病变Fig.ALateral radiograph shows a dense vertebral body(arrows)at L-3.Fig.BSagittal reconstructed CT scan obtained after initial open biopsy reveals not only the L-3 sclerosis but also similar findings in the superior aspect of L-4(arr

11、owheads).Chordoma of L 13-year-old man1-yr history of intermittent low back pain.Fig.AFig.B脊索瘤脊柱肿瘤和肿瘤样病变Sagittal T1WIFig.Cand T2WIFig.D MR images better delineate the marrow involvement at L-3 and L-4 with extension through the disk(arrows).The mass has marked high signal intensity on d.Fig.CFig.D脊柱

12、肿瘤和肿瘤样病变Fig.Egross specimen depicts the extent of the neoplasm,with diffuse involvement of L-3(arrowheads),the adjacent disk(*),and the superior aspect of L-4(arrows).Fig.E脊索瘤脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变Fig.Multiple plasmacytomas with cor

13、d compression.a Sagittal T1WI(left)andbSTIR(right)MRI of thoracic spine show scattered focal lesions involving vertebral bodies and posterior elements of thoracic spine.Bothc transverse and sagittal(a,left)MRI show cord compression by a focal expansile mass(arrow)at the T10 spinous process.abc脊柱肿瘤和肿

14、瘤样病变Myeloma of T5-T7脊柱肿瘤和肿瘤样病变 T1WI STIR T2WI STIR脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变sclerotic metastases脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变Figure.Sagittal T1-weighted MR image of the lumbosacral spine shows multiple hypointense foci within the sacrum and lumbar vertebrae.These lesions remained hypo

15、intense with all of the MR imaging sequences and did not exhibit enhancement.Plain radiography revealed sclerotic metastases.77-yr FMetastatic breast cancer脊柱肿瘤和肿瘤样病变Fig.A:Sagittal T2-weighted MR image demonstrating involvement of the posterior elements of L-3(arrow).Fig.B:Axial T1-weighted MR image

16、 revealing the L-3 spinous process and lamina infiltrated by tumor,with anterior structures intact(arrow).Fig.c:Bone scan demonstrating numerous additional sites of metastatic disease(ribs,skull,and scapula)in addition to L-3(arrow).The patient underwent simple posterior decompression.54-yr Mmetasta

17、tic renal cell carcinomaABC脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变vertebra plana can be seen(arrow)in the thoracic spine,which is consistent with Langerhans cell histiocytosis.8,yr,M of T脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变脊柱肿瘤和肿瘤样病变Thank You脊柱肿瘤和肿瘤样病变