纵隔精原细胞瘤与卵黄囊瘤的CT对照  

Comparison between mediastinal seminoma and yolk sac tumor on CT

作　　者：李斌 陈晓东 夏俊 葛湛 LI Bin;CHEN Xiaodong;XIA Jun;GE Zhan(Department of Radiology,the Affiliated Hospital of Guangdong Medical Universisy,Zhanjiang 524001,China)

机构地区：[1]广东医科大学附属医院放射科,广东湛江524001

出　　处：《实用放射学杂志》2020年第1期50-52,102,共4页Journal of Practical Radiology

摘　　要：目的 对比观察纵隔精原细胞瘤和卵黄囊瘤的CT表现.方法 回顾性分析经病理确诊的 4 例纵隔精原细胞瘤和 4 例纵隔卵黄囊瘤的CT资料,对比观察肿瘤位置、大小、内部结构、病灶内低密度范围比例、强化方式、肿瘤血管、与邻近大血管关系等是否有差异.结果 4 例精原细胞瘤中 2 例密度均匀,2 例实质内见小斑片状低密度区,最大层面低密度区范围比例<2 5%.增强扫描4 例肿块实质均轻度强化,低密度区无强化.4 例肿瘤供血动脉均较少.2 例呈侵袭性生长,包绕邻近大血管呈"血管漂浮征".2 例呈膨胀性生长,周围血管受压移位.4 例卵黄囊瘤密度不均匀,中央见大片低密度区,最大层面低密度区范围比例>75%.增强扫描呈实质中度强化,低密度区无强化,肿瘤呈"花环状"强化改变.肿瘤内可见丰富、迂曲扩张的供血动脉.4 例均呈膨胀性生长,邻近大血管受压移位.结论 纵隔精原细胞瘤 CT 表现为密度较均匀的肿块,轻度强化,肿瘤血管较少,呈浸润性生长,邻近血管包埋;卵黄囊瘤CT表现为密度不均匀的肿块,肿瘤血管丰富,呈膨胀性生长,临近血管受压推移.CT 表现差异有助于两者鉴别.Objective To study comparatively the CT findings of mediastinal seminoma and yolk sac tumor.Methods The CT findings of 4 cases with mediastinal seminoma and 4 cases with mediastinal yolk sac tumor confirmed by pathology were analyzed retrospectively,by studying the tumor location,size,internal structure,proportion of low density range in the lesion,enhancement mode,distribution of inside blood vessels and relationship with adjacent large vessels.Results Among the 4 seminomas,2 showed uniform density while the other 2 indicated small macule like low density with the percentage of low density area in meximum level less than 25%.Light enhancement was seen in the solid portion of mass,but not in low-density area.The supplying arteries of all 4 seminomas decreased.2 grew in aggressive mode with the vessels-floating sign after the neoplasm surrounded adjacent large vessels,while the other 2 grew in cxpanding method with surrounding vessels’displacement due to being pushed.Among the 4 yolk sac tumor,all showed uneven density and large low-density area in the center with the percentage of low-density area in maximum level over 75%.After injecting contrast,media enhancement was found in solid part but not in low-density area,causing the wreath-shaped sign.There were large amount of tortuous and expansive supplying arteries inside the tumor.All 4 lesions grew in expansive mode and pushed the adjacent large vessels leading to the latter's displacement.Conclusion Mediastinal seminoma appears as a relatively dense mass with mild enhancement,tumor blood vessels accum ulate,infiltrative growth,and adjacent blood vessels em bedded;Yolk sac tumor are heterogeneous masses with obvious necrosis and markedly enhanced parenchyma,the tumors are rich in blood vessels and grow expansively.The differences in CT findings are helpful in differential diagnosis between mediastinal seminoma and yolk sac tumor.

关 键 词：纵隔 精原细胞瘤 卵黄囊瘤 计算机体层成像 

分 类 号：R734.5[医药卫生—肿瘤] R814.42[医药卫生—临床医学]