目的探讨颈椎脊索瘤的特征性 影像学表现及其鉴别诊断，以期提高本病 的诊断率。方法 回顾性分析我院经病理 证实的12例颈椎脊索瘤(男7例，女5例)的 临床及影像学资料，分析病变的大小、形 态、密度、信号、边界、强化方式及邻近 结构的改变。结果 单骨发病者11例，多 骨发病者1例，共累及椎体13个。颈椎脊 索瘤主要表现为边界不清的大片状溶骨性 骨质破坏或溶骨性与周边骨质增生硬化合 并的混合性骨质改变，可见骨皮质中断或 不连续。CT以等低密度为主，T1WI为等低 信号，T2WI呈高信号或混杂信号，其内可 见大小不等的点状或条片状高密度钙化影 及点条状低信号纤维分隔影，形成“蜂房 样”改变。增强扫描多呈不均匀强化。结 论 颈椎脊索瘤具有一定的影像学特征， 早期确诊对其术前定位及术后预后评估具 有重要的临床价值。

Objective To explore the CT and MRI findings of the cervical chordoma and its differential diagnosis for imporving the diagnostic accuracy of this disease. Methods Clinical data and imaging findings in 12 patients (7 males, 5 females) with cervical chordoma confirmed by operation and pathologic examination were retrospectively analysed. The size, shape, density, signal, boundary, strengthen and the changes of the adjacent structure of the mass were observed. Results Total of 11 cases infringed the single bone, and only one case infringed the multiple bones. The cervical chordomamainly showed an ill-defined platelike soluble bone destruction or mixed bone changes. The bone cortex of some cases were discontinuous or interrupted. Thecervical chordoma showed equal or low density on CT images with punctiform or platelike high-density calcification in different sizes, and showed heterogeneous equal or low T1 and long or equal T2 signal on MRI images with honeycomb changes which showed long strips of fiber separation with low signal. The tumor mainly showed heterogeneous enhancement after the administration of Gd-DTPA. Conclusions The cervical chordoma has certain imaging characteristics, and theearly diagnostic will be helpful for the preoperative localization and evaluating the postoperative extent.