颅内不同部位生殖细胞瘤的临床及影像特点分析  

Clinical and Neuroimaging Features of Intracranial Germinomas in Different Sites

作　　者：李安宁[1] 吴越[1] 王静[1] 姚振威[1] 冯晓源[1] 

机构地区：[1]复旦大学附属华山医院放射科

出　　处：《中国医学计算机成像杂志》2014年第1期5-9,共5页Chinese Computed Medical Imaging

基　　金：卫生部重点学科建设基金(卫生部74)~~

摘　　要：目的:分析颅内不同部位生殖细胞瘤的临床及影像特点以提高对本病的认识。方法:回顾性分析70例颅内生殖细胞瘤患者的临床和影像资料(包括CT和MRI)。其中49例有效的影像资料,包括17例行头颅CT平扫,47例行MR轴位T1W、T2W、DWI、增强后T1W序列扫描。结果:70例患者主要临床症状为:鞍区病变主要表现为尿崩,基底节病灶主要为轻偏瘫,松果体病灶主要表现为头痛、视力下降、眩晕、呕吐。49例神经影像表现:CT平扫表现为稍高密度,MR增强扫描呈显著强化,囊变率55.8%,部分病灶可见弥散稍高信号。从形态上,松果体区生殖细胞瘤主要表现为边界清晰的圆形或者椭圆形的肿块。鞍区生殖细胞瘤可分为3类:垂体柄结节病灶、V形或Y形病灶、不规则形肿块。所占比例分别为3/30(10%)、17/30(56.7%)及10/30(33.3%)。发生于基底节区及丘脑的生殖细胞瘤主要表现为簇状结节加囊变病灶。结论:颅内生殖细胞瘤的临床及影像特点同肿瘤的发生部位密切相关。鞍区病灶具有不同的形态学特点。Purpose： To study the clinical and imaging features of intracranial germinomas in different sites. Methods： Clinical data and imaging studies including computed tomography （CT） and magnetic resonance imaging （MRI） were retrospectively analyzed in 70 patients with surgically and pathologically verified intracranial germinomas. CT studies were performed in axial plane without iodinated contrast material administration; MR studies consisted of axial TI-, T2-, DWI, and post-contrast Tl-weighted sequences and coronal or sagittal, pre- and post- contrast Tl-weighted sequences. Results： The main clinical symptoms or signs of 70 cases were： diabetes insipitus, hemiparesis, headache, visual loss, dizzy, and vomiting. These clinical appearances were evidently depended on where the lesions located. Forty- nine cases had neuroimaging data, and on 17 cases of CT scan, all of the lesions showed high density and 7 with calcifications. MRI showed evident enhancement, 55.8% of the cases were with cystic change, part of the lesions were with high signal intensity on DWI. Morphologically, pineal germinoma appeared as well- defined round or oval mass. Sellar germinoma could be classified into 3 types： stalk nodule, V or Y-shaped, and irregular mass, which covered 3/30（10%）, 17/30（56.7%） and 10/30（33.3%） respectively. Basal ganglia and thalamus lesions were mainly shown as cluster nodules with or without cysts. Conclusion： The clinical and radiological features of intraeranial germinomas are strongly correlated to where the lesions locate. Sellar germinomas are with different morphological features.

关 键 词：生殖细胞瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]