不同亚型颅底脊索瘤的影像诊断及预后分析

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MedicalImagigCenter，GanzhouPeople'sHospital，SouthernHospitalGnzhouranchGanzhou4o，Chna;MedicalIing Center，YuduCountyHospitalofadionalCineseMedicine，Yudu3423o，China;FirstClinicaledicalCollgeofuth MedicalUniversity，SouthernHospital，Guangzhou51o515，China. [Abstract]Objective：ToinvestigatetheCTandMRIdiagnosticimagingofdiferentsubtypesofskullbasechordomaandthe prognosisanalysisof diferenttreatment methods.Methods：Atotalof67casesof skullbase chordomaconfimedby CTand MRI examinationsandpathologywerecoleted，andthediseasecoursewas followedupfor1-119months.Results：Among the67cases，49caseswereoftheclassictype，1wereofthechondroidtype，and8wereofthedediferentiatedtype.There werenosignificantdiferencesinage，gender，tumor location，diameterand treatmentamong thethreesubtypes（ll P>0.05 ）. TheKi-67expressioninclassicandchondroidtypeswerelow，whilethatindediferentiatedtypewasmediumandhigh， the difference was statistically significant（ P =0.048）．The bone destruction，bone fragments statues，and the plain scan and enhanced CT values in the three subtypes were significantly different （all P <0.05），while the tumor boundary，growth pattern，calcification，fibrous septum，T1WI and TWI signal intensity，enhancement pattern，cystic change were not statistically different（all P>0.05 ）.Women had longer disease-free survival （DFS）than men（ P=0.011 ），the dediferentiation type had shorter DFS than the classic type（ P =0.001），and the chondroid type had longer overall survival（OS）than the classic type（ P=0.031 ）.Compared with the treatment of complete surgical resection，the treatment methodof surgery combined with radiotherapy after recurrenceandthe method of biopsy alone without treatment had the shorter OS（ P =0.015，0.004）. Conclusions：TheplainscanandenhancedCTvaluesofthedediferentiatedchordomaarethehighest.Patientswith skul basechordoma should receiveadjuvant radiotherapy immediately after the first surgery to improve the prognosis. [Key words] Chordoma of skullbase;Tomography，X-ray computed;Magnetic resonance imaging;Prognosis

脊索瘤是一种低中度恶性骨肿瘤，起源于脊索发育的残留组织，因此几乎只发生于中轴骨，位于颅底区的脊索瘤约占 35%[2] 。（剩余6782字）