胸段脊髓髓内神经鞘瘤1例并文献复习

目的探讨髓内神经鞘瘤的临床、影像学表现及治疗方式。方法回顾性分析1例胸段脊髓髓内神经鞘瘤患者的临床资料，并对相关文献进行复习。结果本例患者女，35岁，表现双下肢麻木、无力、尿潴留、大便困难，病情进行性加重；胸椎MRI检查示，T8-T9水平脊髓稍增粗，脊髓内结节状等T1、稍长T2信号影，边缘清楚，增强扫描呈轻-中度强化。行手术全切除脊髓内病变，术后患者的症状得到明显改善。术后病理检查诊断为髓内神经鞘瘤。结论髓内神经鞘瘤临床罕见，术前诊断困难，治疗方法以手术切除肿瘤为主。

Abstract： Objective To investigate the clinical, imaging manifestations and treatment of intramedullary schwannoma. Methods The clinical data of one patient with intramedullary neurilemmoma of thoracic spinal cord were analyzed retrospectively, and the related literature was reviewed. Result The case of a 35-year-old woman presented with numbness, weakness, retention of urine and difficulty in defecation. Her chest MRI examination showed that the T8-T9 level slightly thickened, the nodules in the spinal cord were T1, and the T2 signal was slightly longer. The edge was clear, and the enhancement scan was mild to moderate. After total resection of spinal cord lesions, the patient’s symptoms were significantly improved. Postoperative pathological examination showed intramedullary schwannoma. Conclusions Intramedullary schwannoma is rare and difficult to diagnose preoperatively.