儿童松果体区肿瘤的临床及影像学特征

发布时间：2018-03-14 19:43

本文选题：松果体瘤　切入点：磁共振成像　出处：《放射学实践》2017年06期 　论文类型：期刊论文

【摘要】：目的:探讨儿童松果体区肿瘤的临床及影像学特征,旨在提高术前诊断水平。方法:回顾性分析手术病理证实的42例儿童松果体区肿瘤临床资料(性别、年龄、主要临床症状、肿瘤指标)及影像学表现。结果:42例中,生殖细胞源性肿瘤25例(混合性生殖细胞瘤11例、畸胎瘤11例、生殖细胞瘤3例),男性占92%,平均年龄为(7.6±3.3)岁。9例有甲胎蛋白(AFP)升高,人绒毛膜促性腺激素(HCG)升高6例;松果体母细胞瘤12例,其中1例合并双侧视网膜母细胞瘤,平均年龄(2.7±1.9)岁;毛细胞型星形细胞瘤5例,平均年龄(6.4±2.7)岁。临床表现以颅内高压引起的头痛、恶心、呕吐为主(69%),少数表现为视力障碍、性早熟。不少肿瘤的CT和MR表现有一定相似之处,但有些肿瘤还是具有一定特征。结论:儿童松果体区肿瘤以生殖细胞肿瘤多见,其中以混合性生殖细胞瘤、畸胎瘤多见,影像学表现结合生化指标对肿瘤的定性非常重要。松果体母细胞瘤发病率也较高,影像表现与生殖细胞瘤非常相似,年龄较小是鉴别要点。
[Abstract]:Objective: to investigate the clinical and imaging features of pineal region tumors in children, in order to improve the preoperative diagnosis. Methods: the clinical data (sex, age, main clinical symptoms) of 42 children with pineal region tumors proved by surgery and pathology were retrospectively analyzed. Results of 42 cases, 25 cases (11 cases of mixed germ cell tumor, 11 cases of teratoma, 3 cases of germ cell tumor) and 92 cases of male (mean age of 7.6 卤3.3) years had elevated AFP. There were 6 cases of human chorionic gonadotropin (HCG) elevation, 12 cases of pinealoblastoma, 1 case of bilateral retinoblastoma with an average age of 2.7 卤1.9 years, 5 cases of hair cell type astrocytoma, 5 cases of human chorionic gonadotropin, 12 cases of pinealoblastoma and 1 case of bilateral retinoblastoma. The average age was 6.4 卤2.7 years old. The clinical manifestations were headache, nausea and vomiting caused by intracranial hypertension. A few of them showed visual impairment and precocious puberty. The CT and Mr findings of many tumors were similar to each other. Conclusion: germinating cell tumors are more common in children with pineal region, among which mixed germ cell tumor and teratoma are the most common tumors. Imaging findings combined with biochemical indicators are very important for the qualitative analysis of the tumor. The incidence of pinealoblastoma is also high. The imaging findings are very similar to those of germinoma, and younger age is the main point of differentiation.
【作者单位】：上海交通大学医学院附属新华医院放射科;
【分类号】：R445.2;R730.44;R739.41

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