青少年松果体区肿瘤MRI影像特点及病理分析  

MRI features and pathological analysis of adolescent pineal tumor

作　　者：张泉 赵恺[1] 王俊文[1] 张所军 柯昌庶[2] 万锋[1] 舒凯[1] 雷霆[1] ZHANG Quan;ZHAO Kai;WANG Junwen(Department of Neurosurgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,武汉430030 [2]华中科技大学同济医学院附属同济医院病理科,武汉430030

出　　处：《临床外科杂志》2019年第10期846-849,共4页Journal of Clinical Surgery

基　　金：国家自然科学基金资助项目(81602204);2015武汉市创新人才开发资金资助项目(2015whcxrczjxm02);华中科技大学同济医学院研究型临床医师资助计划(5001540025)

摘　　要：目的探讨青少年松果体区肿瘤(pineal region tumors,PRTs)影像特点与病理类型的相关性。方法回顾性分析35例青少年PRTs的临床资料,分析影像学表现和病理类型的相关性。结果35例青少年PRTs中生殖细胞肿瘤19例,松果体实质细胞瘤6例,星形细胞瘤7例,其他类型3例。生殖细胞肿瘤MRI主要表现为等或稍短T1信号,稍长T2信号,增强扫描多均匀明显强化,可见坏死及钙化。松果体母细胞肿瘤好发于青少年,MRI多呈短T1、T2信号,显著均匀强化;坏死多见,钙化少见。星形细胞瘤体积较大,多见囊变,MRI呈均匀等T1、T2信号,实质部分不同程度强化,囊性部分多不强化,基本无坏死钙化。结论青少年最常见的PRTs主要为生殖细胞肿瘤,低级别星形细胞瘤和松果体母细胞瘤。不同病理类型的松果体区肿瘤的影像学表现具有一定的特异性,结合临床资料综合分析有助于术前定性诊断。Objective To determine the correlation between image characteristics and pathology of pineal region tumors(PRTs)in adolescence.Methods The clinical data of the correlation between imaging findings and pathological types of 35 patients of PRTs in adolescence confirmed by postoperational pathological analysis were analyzed retrospectively.Results 35 patients with surgically and pathologically proved PRTs which comprised germinoma(n=19),pinealoma(n=6),astrocytoma(n=7)and others(n=3).Germinoma lesions were isointensity or hypointensity on T1WI and slight hyperintensity on T2WI.Following enhanced scans,the tumors were obviously homogeneous enhancement.Additionally,the intratumoral calcification and tumor necrosis were often observed.Pineoblastoma lesions were hypointensity on T1WI and T2WI,obviously enhancement followed by enhanced scans.Tumor necrosis was often observed while intratumoral calcification was rare.Astrocytoma lesions were large in PRT with intratumoral cystic change but without intratumoral calcification and tumor necrosis.The tumors were isointensity on T1WI and T2WI.Following the enhanced scans,tumor cystic region were non-enhancement and tumor solid part were homogeneous enhancement.Conclusion Germinoma,astrocytoma and pineoblastoma were the most common pathological type of PRTs in adolescence.Due to the specific image features of different pathological tumors described above,we could make the preoperative qualitative diagnosis of PRTs accurately by analyzing the preoperational image data and the clinical features.

关 键 词：青少年 松果体区肿瘤 影像学 病理学 

分 类 号：R73[医药卫生—肿瘤]