颅内不典型生殖细胞瘤MRI表现

发布时间：2018-01-08 04:11

本文关键词：颅内不典型生殖细胞瘤MRI表现　出处：《临床放射学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨颅内不典型生殖细胞瘤MRI特征。方法搜集2009年7月至2016年3月经本院病理证实或诊断性放射治疗证实的20例颅内不典型生殖细胞瘤患者MRI资料。所有患者均行常规MRI检查,其中4例患者行磁共振波谱(MRS)、3例行磁共振血管成像(MRA)检查。详细分析不同部位的颅内不典型生殖细胞瘤的MRI表现。结果 20例患者,男18例,女2例,平均年龄(14±0.4)岁,发病部位依次为基底节区9例、侧脑室4例、左侧额叶3例、脑干2例、下丘脑-垂体2例。不同部位肿瘤的MRI表现不一:基底节生殖细胞瘤囊变出血多见,轻中度不均匀强化,5例出现不同程度脑萎缩,表现为同侧脑沟增宽、脑室扩大及同侧中脑大脑脚变细,其中3例行MRA检查,2例表现为同侧大脑中动脉分支稀疏;侧脑室生殖细胞瘤出血多见;脑干生殖细胞瘤以囊变为主,呈环形强化;额叶生殖细胞瘤MRI表现多样,可呈实性或囊变;下丘脑-垂体生殖细胞瘤表现为垂体柄增粗、垂体增大。4例患者MRS显示病变区域N-乙酰天门冬氨酸(NAA)峰、肌酸(Cr)峰降低,胆碱(Cho)峰降低或升高,均出现乳酸(Lac)峰。4例患者合并松果体区结节,5例患者合并垂体柄结节。结论不同部位的颅内不典型生殖细胞瘤具有不同的MRI表现,掌握各种部位肿瘤的MRI特征,有利于提高不典型生殖细胞瘤的诊断率,从而指导临床选择合适的诊疗方案。
[Abstract]:Objective to investigate the MRI features of intracranial atypical germ cell tumor. Methods from July 2009 to 2016, 20 cases of intracranial atypical germ cell tumor confirmed by pathology or diagnostic radiotherapy were collected. All patients underwent routine MRI examination. Magnetic resonance spectroscopy (MRS) was performed in 4 of them. Three cases were examined by magnetic resonance angiography (MRA). The MRI findings of different parts of intracranial atypical germ cell tumor were analyzed in detail. Results there were 20 patients (18 males and 2 females). The mean age was 14 卤0.4 years old. 9 cases were located in basal ganglia, 4 cases in lateral ventricle, 3 cases in left frontal lobe and 2 cases in brainstem. There were 2 cases of hypothalamus-hypophysis. The MRI manifestations of different tumors were different: basal ganglia germ cell tumor was more common in cystic hemorrhage, mild to moderate heterogeneous enhancement in 5 cases with different degrees of brain atrophy, showing enlargement of the ipsilateral sulcus. Ventricular dilatation and thinning of the ipsilateral midbrain cerebral foot were observed in 3 cases. 2 cases showed sparse branches of the middle cerebral artery on the ipsilateral side by MRA. Hemorrhage of lateral ventricle germinoma was more common. Brain stem germ cell tumor was mainly cystic with circular enhancement. The MRI findings of frontal germ cell tumor were various and could be solid or cystic. The hypothalamus-pituitary germ cell tumor was characterized by thickening of pituitary stalk, and MRS showed the peak of N-acetylaspartic acid (NAA) and creatine (Cr) decreased in the lesion area of 4 patients with pituitary enlargement. The peak of choline Chois decreased or increased, and lactate Lacs peak appeared in 4 patients with pineal nodule. Conclusion Intracranial atypical germinoma has different MRI features, and can master the MRI features of various tumors. It is helpful to improve the diagnosis rate of atypical germ cell tumor and to guide the clinical selection of appropriate diagnosis and treatment.
【作者单位】：中南大学湘雅医院放射科;湖南省株洲市茶陵县人民医院;
【分类号】：R445.2;R739.41
【正文快照】： 生殖细胞瘤为生殖细胞类肿瘤最常见的类型,为基底节区9例,侧脑室4例,左侧额叶3例,下丘起源于原始未分化的胚胎生殖细胞。颅内生殖细胞脑-垂体2例,脑干2例。血清AFP升高者1例,β-瘤大部分发生于20岁以下的青少年男性[1],典型好HCG升高者2例,AFP与β-HCG均升高者1例。发部位为松

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