儿童及青少年颅内生殖细胞瘤的临床和影像学特点

发布时间：2018-05-31 12:45

本文选题：脑肿瘤 + 生殖细胞瘤　；参考：《中国临床医学影像杂志》2017年08期

【摘要】：目的 :探讨儿童及青少年颅内生殖细胞瘤的临床表现及影像学特点,以提高对本病的认识。方法 :回顾性分析45例经病理或随访证实的不同部位颅内生殖细胞瘤患者临床表现及影像学的特点。结果:7例(16%)位于松果体区,均为男性,平均11岁,主要临床表现为颅内高压(71%),3例行CT平扫,显示等高密度含钙化的类圆形肿块,MRI显示T_1WI及T_2WI等信号、DWI等(27%)或稍高(73%)信号的肿块,增强后明显强化。24例(53%)位于鞍区,75%为女性,平均10岁,主要临床表现为尿崩症(83%),6例行CT平扫,肿块显示为等高密度,但无一钙化,MRI显示94%为形态各异的肿块,其中36%伴小囊变,实性部分影像表现类似松果体区肿瘤,6%仅表现为垂体柄结节样增粗。10例(22%)位于丘脑基底节区,90%为男性,平均11岁,主要临床表现为轻偏瘫(70%),7例行CT平扫,显示肿块实性部分高密度,57%含钙化,MRI显示不规则的T_1WI及T_2WI等信号、DWI等(44%)或稍高(56%)信号,增强后中度强化,50%伴囊变或出血,38%伴偏侧脑萎缩。多中心病变占9%,75%为男性,临床表现与其中某一部位损害类似,影像学表现也与该部位特点相同。结论:10~12岁是颅内生殖细胞瘤主要发病年龄,松果体区、鞍区及丘脑基底节区为好发部位,松果体区及丘脑基底节区男性占绝对优势,不同部位生殖细胞瘤的临床及影像学表现各具特点,两者结合能提高对颅内生殖细胞瘤的诊断。
[Abstract]:Objective: to investigate the clinical and imaging features of intracranial germinoma in children and adolescents. Methods: the clinical and imaging features of 45 patients with intracranial germinoma confirmed by pathology or follow-up were retrospectively analyzed. Results in the pineal region of 7 cases, all of them were male with an average age of 11 years. The main clinical manifestations were CT plain scan of intracranial hypertension in 3 cases, showing the mass with T_1WI and T_2WI signals (27%) or slightly higher signal intensity (73). After enhancement, 75% of the women were located in the Sellar area, with an average age of 10 years. The main clinical manifestations were diabetes insipidus, 833% of them were plain CT scan, the mass showed iso-high density, but no calcified MRI showed 94% of the tumors, 36% of which were accompanied with small cystic change. Solid partial imaging was similar to pineal region tumor in 6%. Only 10 cases presented as pituitary stalk nodular thickening. 90% of them were male (mean 11 years old) located in basal ganglia of thalamus. The main clinical manifestations were 70% of hemiplegia and 7 cases of CT plain scan. MRI showed irregular T_1WI and T_2WI signals (44) or slightly higher (56%). After enhancement, 50% of the lesions were moderately enhanced with cystic degeneration or hemorrhage and 38% with hemiatrophy. Multicentric lesions accounted for 75% of the male lesions. The clinical manifestation was similar to that of one of the lesions, and the imaging features were the same. Conclusion the age of 12 years old is the main age of intracranial germinoma. The pineal region, Sellar region and basal ganglia of thalamus are the predilection sites, and the pineal and thalamic basal ganglia are the dominant male. The clinical and imaging features of germinoma are different, and the combination of the two can improve the diagnosis of intracranial germinoma.
【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;R739.4

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