鞍区生殖细胞肿瘤的 MRI 诊断  

MRI diagnosis of sellar germ cell tumors

作　　者：李俊荣[1] 赵建洪[1] 周俊林[1] 罗永军[1] 柴成奎 赵君[1] 

机构地区：[1]兰州大学第二医院放射科,甘肃兰州730030 [2]山东省寿光医院放射科

出　　处：《实用放射学杂志》2014年第12期1971-1973,2009,共4页Journal of Practical Radiology

摘　　要：目的：探讨颅内鞍区生殖细胞肿瘤的 MRI 表现特征,为临床治疗方法的选择提供参考。方法回顾性分析44例经手术病理证实的颅内鞍区生殖细胞肿瘤的影像及病理资料。结果生殖细胞瘤19例,边界多较清楚,见不同程度囊变坏死,瘤周水肿多较轻；增强扫描均呈明显强化。成熟型畸胎瘤8例,多呈囊实性改变,T1 WI、T2 WI 平扫均呈混杂信号病变。恶性畸胎瘤（未成熟型畸胎瘤和畸胎瘤恶变）11例,其实性成分较成熟型畸胎瘤多；增强扫描实性部分明显强化；2例卵黄囊瘤 T1 WI、T2 WI 平扫信号多较均匀,增强扫描呈明显均匀强化,血清 AFP 明显升高。2例胚胎性癌边界较清楚,其内信号不均,可见明显囊变坏死,灶周可见中~重度水肿,增强扫描实性部分呈明显强化。2例混合性生殖细胞瘤信号不典型,取决于其内所含肿瘤类型。结论颅内鞍区生殖细胞肿瘤 MRI 表现有一定特征性。Objective To explore the MRI features of germ cell tumors in sellar regions for better developing clinical treatment plans.Methods The imaging and pathologic findings of 44 sellar germ cell tumors were retrospectively analyzed.Results There were 1 9 germinoma,most of which had clear boundaries,different extents of cystic necrosis and mild peritumoral edema.Lesions were significantly enhanced in contrast-enhanced MRI （CE-MRI）.There were 8 cases with mature teratoma,most showed cystic-solid changes,presenting mixed-intensities on T1-weighted images and T2-weighted images.There were 1 1 malignant teratoma（im-mature teratoma and teratoma malformation ）,however,there were more parenchymatous tissue in malignant teratoma than mature teratoma.Two yolk sac tumors showed uniform signals on T1-weighted images and T2-weighted images,significant enhancement on CE-MRI,and visibly higher AFP in serum.Two embryonal carcinomas had clear boundary,inhomogeneous intensities,visibly cyst-ic necrosis,median to servere peritumoral edema,the parenchyma showed significant enhancement in CE-MRI.The signals of two mixed germ cell tumors were not typical,which depended on the components within tumors.Conclusion The MRI features of germ cell tumors in sellar region are characteristic.

关 键 词：颅内 生殖细胞肿瘤 磁共振成像 病理学 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]