性腺外原发性精原细胞瘤CT与MRI表现  

CT and MRI features of extragonadal primary seminoma

作　　者：李健[1] 谢凯[1] 龚洪翰[1] 王慧芳[1] 张慧芳[1] 曾献军[1] 何来昌[1] 

机构地区：[1]南昌大学第一附属医院影像科,江西南昌330006

出　　处：《实用放射学杂志》2016年第4期562-565,共4页Journal of Practical Radiology

摘　　要：目的 探讨性腺外原发性精原细胞瘤的CT与MRI表现，提高对该肿瘤的术前诊断率。方法 回顾性分析经病理证实的8例性腺外原发性精原细胞瘤的临床及CT、MRI表现。结果 8例中，4例位于颅内，4例位于腹盆腔。肿瘤位于基底节丘脑区2例，呈类圆形囊实性肿块，密度或信号不均，囊变坏死明显而周围水肿轻，增强扫描不均匀显著强化，其中1例伴出血并沿脑室播散转移。松果体区1例，不规则分叶状，MRI平扫表现为T1WI稍低信号，T2WI等、稍高信号，增强扫描肿块明显强化，周边见条片状无强化囊变区。鞍区1例，CT平扫病灶呈稍高密度，MRI表现为T1WI等信号，T2WI等、稍高信号，侵犯垂体，垂体柄受累增粗，增强扫描鞍上肿块呈较均匀明显强化，累及视交叉，胼胝体嘴部见明显强化小结节灶。腹盆腔4例，CT表现均为分叶状软组织肿块,边界欠清，呈浸润性生长，内见不同程度囊变坏死区，增强扫描呈轻中度强化，内见多发迂曲血管影，腹膜后及肠系膜根部见肿大淋巴结。结论 性腺外原发性精原细胞瘤少见，影像学表现具有一定特征性，结合临床资料可提高对其术前诊断率。Objective To investigate CT and MRI features of extragonadal primary seminoma and improve its diagnostic accuracy. Methods The clinical and imaging features of 8 patients with extragonadal primary seminoma proved by histopathology were analyzed retrospectively. Results In 8 cases,4 cases were located in intraeranial regions, 4 cases in the abdominal and pelvic cavity. Detailedly, roundlike solid and cystic tumors were seen in the basal ganglia and thalamus in 2 cases. The mass density and signal were inhomogeneous in the necrotic area with slight peritumoral edema and heterogeneous enhancement, and hemorrhage and metastasis of the third ventricle were occurred inone case. Shallow lobulated tumor was occurred in the pineal region forone case, which MRI features included slightly low signal on T1 WI,equal or higher signal on T2 WI,with obvious enhancement and peripheral cystic change. There was one case in the sella area with slight high density on CT routine scan, and on MRI, slight equal signal on TlWI,equal or higher signal on T2WI. The pituitary stalk was involved with thickening. Tumor in suprasellar region was obviously enhanced, with a small uniformity enhancement nodule in the mouth of corpus callosum. 4 cases were occurred in the abdominal and pelvic cavity, shallow lobulated tumors with varying degrees of necrosis were found on CT with infiltrating growth and slight to moderate enhancement, and swollen lymph nodes were found in retroperitoneal and mesenteric root areas. Conclusion Extragonadal primary seminoma is rare,there are some characteristic imaging findings, which contributes to improve diagnosis accuracy when combining with clinical data.

关 键 词：性腺外 精原细胞瘤 计算机体层成像 磁共振成像 

分 类 号：R737[医药卫生—肿瘤] R814.42[医药卫生—临床医学]