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脊髓转移瘤(intramedullary spinal cord metastases,ISCM)是恶性肿瘤发展过程中危害性最大的一种转移性疾病,它常常压迫脊髓或神经根,导致机体瘫痪等神经损害,使患者的生活质量显著降低。ISCM临床表现缺乏特异性,且患者大多处于疾病进展期,病情发展迅速,因此,如何尽早地明确诊断,及时给予患者有效的治疗是临床医生目前面临的难题。本文主要就近年来ISCM的影像学诊断与治疗的研究进展进行综述。
脊髓转移瘤的影像学诊断与治疗研究进展
Progress in imaging diagnosis and treatment of intramedullary spinal cord metastases
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摘要: 脊髓转移瘤(ISCM)是肿瘤晚期患者癌灶转移至脊髓,压迫脊髓或神经根引起躯体疼痛、感觉减退或麻木的一种危险的转移性疾病,严重者可导致机体瘫痪,患者的生活质量显著降低。随着肿瘤发病率的上升以及新型影像诊断技术在临床中的应用,ISCM的检出率明显提高。但遗憾的是,针对ISCM的治疗目前尚无统一的共识。虽然在以往的ISCM治疗中放疗的作用较为局限,但随着放疗技术的发展与提高,对于存在手术禁忌证或化疗效果较差的患者,放疗已成为其主要的治疗方式。笔者就近年来ISCM的影像学诊断与治疗研究进展做一综述。
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关键词:
- 脊髓 /
- 肿瘤转移 /
- 磁共振成像 /
- 体层摄影术, X线计算机 /
- 放射疗法
Abstract: Intramedullary spinal cord metastasis (ISCM) is a dangerous metastatic disease among advanced cancer patients with tumor metastases in the spinal cord because it compresses the spinal cord or nerve root. This phenomenon can cause pain, hypoesthesia, or numbness, especially in severe cases, leading to paralysis of the body and significantly reduced quality of life. With the increase in tumor morbidity and the application of new imaging diagnostic techniques in clinical practice, the detection rate of ISCM has significantly improved. Unfortunately, a consensus on ISCM treatment remains lacking to date. In addition, the role of radiotherapy in previous ISCM treatment strategies is limited. However, the development and improvement of radiotherapy have rendered this technology the main treatment for patients who cannot be treated surgically or are insensitive to chemotherapy. This article reviews the progress in imaging diagnosis and treatment of ISCM. -
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