儿童及青少年松果体区生殖细胞肿瘤的CT、MRI表现
|
摘要
目的分析儿童及青少年松果体区生殖细胞肿瘤(GCTs)的CT、MRI表现。方法收集24例GCTs患者的临床资料,结合病理分析其CT及MRI特点。结果生殖细胞瘤13例,CT平扫呈稍低或等密度,MRI呈T1WI等低、T2WI等高信号,多伴钙化及小囊变,增强扫描明显强化。畸胎瘤5例,平扫密度/信号混杂,瘤体内含不同比例脂肪及钙化,增强后强化不均。内胚窦瘤3例,CT平扫呈等低密度,MRI平扫呈较均匀T1WI低、T2WI高信号,部分病灶内含黏液囊腔,增强扫描均匀或不均匀强化。胚胎性癌2例,CT/MRI平扫密度/信号混杂,可伴明显液化坏死,增强扫描不均匀强化,瘤周水肿显著。混合性生殖细胞瘤1例,平扫密度/信号混杂,增强扫描强化不均。结论儿童及青少年松果体区GCTs影像表现多样,部分肿瘤具有一定特征性,结合肿瘤标志物及发病年龄等临床特点有助于提高诊断准确性。
Objective To analyze the CT and MRI manifestations of germ cell tumor in children and adolescents.Methods Clinical data of 24 patients with GCTs were collected,and CT and MRI characteristics were analyzed and compared with pathological analysis.Results There were 13 cases of germinal cell tumor,and the CT scan was slightly lower or equal density,and the MRI showed a low T1WI and a high signal of T2WI,accompanied by calcification and microcystic changes,and was significantly enhanced.In 5 cases of teratoma,the density/signal was mixed,and the tumor contained different proportions of fat and calcification,which enhanced the unevenness.In 3 cases of endodermal sinus tumor,CT scan showed low density,and MRI scan showed a relatively uniform T1WI low and T2WI high signal.Some lesions had mucous cystic lumen,and enhanced scanning was uniform or non-uniform.In 2 cases of embryonic carcinoma,CT/MRI scanning density/signal was mixed,with obvious liquefaction necrosis,inhomogeneity enhancement,and significant edema around the tumor.In the case of mixed germ cell tumor,the density/signal was mixed,and enhanced obviously.Conclusion There is a variety of images of GCTs in children and adolescents,and some tumors have certain characteristics,which can help to improve the accuracy of diagnosis in combination with clinical features such as tumor markers and age of onset.
Objective To analyze the CT and MRI manifestations of germ cell tumor in children and adolescents.Methods Clinical data of 24 patients with GCTs were collected,and CT and MRI characteristics were analyzed and compared with pathological analysis.Results There were 13 cases of germinal cell tumor,and the CT scan was slightly lower or equal density,and the MRI showed a low T1WI and a high signal of T2WI,accompanied by calcification and microcystic changes,and was significantly enhanced.In 5 cases of teratoma,the density/signal was mixed,and the tumor contained different proportions of fat and calcification,which enhanced the unevenness.In 3 cases of endodermal sinus tumor,CT scan showed low density,and MRI scan showed a relatively uniform T1WI low and T2WI high signal.Some lesions had mucous cystic lumen,and enhanced scanning was uniform or non-uniform.In 2 cases of embryonic carcinoma,CT/MRI scanning density/signal was mixed,with obvious liquefaction necrosis,inhomogeneity enhancement,and significant edema around the tumor.In the case of mixed germ cell tumor,the density/signal was mixed,and enhanced obviously.Conclusion There is a variety of images of GCTs in children and adolescents,and some tumors have certain characteristics,which can help to improve the accuracy of diagnosis in combination with clinical features such as tumor markers and age of onset.
引文
[1]祁佩红,李四保,郑红伟,等.松果体区少见类型生殖细胞肿瘤的M R I表现[J].临床放射学杂志,2016,35(7):998-1002.
[2]柴成奎,周俊林.颅内生殖细胞肿瘤研究进展[J].中国CT和MRI杂志,2012,10(5):101-105.
[3]Louis DN,Perry A,Reifenberger G,et al.The 2016 World Health Organization Classification of Tumors of the Central Nervous System:a summary[J].Acta Neuropa-thologica,2016,131(6):803-820.
[4]赵亚鹏,张玉琪,段虹宇,等.颅内混合性生殖细胞肿瘤诊治效果分析[J].中华医学杂志,2017,97(9):661-665.
[5]李俊荣,赵建洪,罗永军,等.颅内少见组织学类型生殖细胞肿瘤的MRI诊断[J].兰州大学学报(医学版),2014,40(3):52-56.
[6]王翦,赵义营,杨群英,等.儿童中枢神经系统肿瘤219例临床分析[J].广东医学,2015,36(17):2621-2624.
[7]赵亚鹏,张玉琪,段虹宇,等.颅内生殖细胞肿瘤的个体化治疗[J].中华神经外科杂志,2017,33(3):260-264.
[8]梅鑫,李玉华,刘明,等.儿童松果体区肿瘤的临床及影像学特征[J].放射学实践,2017,32(6):608-614.
[9]刘孟辉,彭双林,刘建玲,等.颅内不典型生殖细胞瘤MRI表现[J].临床放射学杂志,2017,36(8):1062-1066.
[10]齐草源,邹丽丽,茹小娟,等.中分化松果体实质瘤影像学表现(附31例报告)[J].中国医学影像技术,2015,31(7):985-988.
[11]吴婧雯,王显龙,林燕红,等.颅内畸胎瘤的CT和MRI诊断[J].中华神经医学杂志,2015,14(9):890-893.
[12]刘震,张萍,张佩娟,等.16例脑室内中枢神经细胞瘤患者M R I误诊分析[J].中国C T和M R I杂志,2015,15(9):18-21.
[2]柴成奎,周俊林.颅内生殖细胞肿瘤研究进展[J].中国CT和MRI杂志,2012,10(5):101-105.
[3]Louis DN,Perry A,Reifenberger G,et al.The 2016 World Health Organization Classification of Tumors of the Central Nervous System:a summary[J].Acta Neuropa-thologica,2016,131(6):803-820.
[4]赵亚鹏,张玉琪,段虹宇,等.颅内混合性生殖细胞肿瘤诊治效果分析[J].中华医学杂志,2017,97(9):661-665.
[5]李俊荣,赵建洪,罗永军,等.颅内少见组织学类型生殖细胞肿瘤的MRI诊断[J].兰州大学学报(医学版),2014,40(3):52-56.
[6]王翦,赵义营,杨群英,等.儿童中枢神经系统肿瘤219例临床分析[J].广东医学,2015,36(17):2621-2624.
[7]赵亚鹏,张玉琪,段虹宇,等.颅内生殖细胞肿瘤的个体化治疗[J].中华神经外科杂志,2017,33(3):260-264.
[8]梅鑫,李玉华,刘明,等.儿童松果体区肿瘤的临床及影像学特征[J].放射学实践,2017,32(6):608-614.
[9]刘孟辉,彭双林,刘建玲,等.颅内不典型生殖细胞瘤MRI表现[J].临床放射学杂志,2017,36(8):1062-1066.
[10]齐草源,邹丽丽,茹小娟,等.中分化松果体实质瘤影像学表现(附31例报告)[J].中国医学影像技术,2015,31(7):985-988.
[11]吴婧雯,王显龙,林燕红,等.颅内畸胎瘤的CT和MRI诊断[J].中华神经医学杂志,2015,14(9):890-893.
[12]刘震,张萍,张佩娟,等.16例脑室内中枢神经细胞瘤患者M R I误诊分析[J].中国C T和M R I杂志,2015,15(9):18-21.