颈髓髓内神经鞘瘤1例
Chinese Journal of Medical Imaging Technology（2020）
Abstract
患者女,61岁,无明显诱因四肢无力1.5年,以右侧肢体为重,伴麻木感,加重2个月.查体:双侧小腿肿胀;右侧肢体近端肌力3级,远端肌力2级;左侧肢体近端肌力4级,远端肌力3级;左上肢远端、右上肢、双下肢痛觉减退,右侧为著;双侧巴宾斯基征、右侧霍夫曼征(+).实验室检查未见明显异常.颈椎MRI示C3～4水平椎管内稍长T1稍长T2信号肿块,T2WI信号欠均匀,周围脊髓水肿增粗(图1A、1B),增强后肿块均匀强化(图1C);考虑髓内病变(星形细胞瘤可能性大).行C3～4椎管内占位性病变切除术,术中见髓内灰红色肿物,质地硬、韧、血运丰富,脊髓受压变薄呈纸样.
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