原发性纵隔混合型恶性生殖细胞瘤的影像学表现  

Imaging findings of primary mediastinal mixed germ cell tumors

作　　者：梁锐烘 刘艳雯 曾庆思[1] LIANG Ruihong;LIU Yanwen;ZENG Qingsi(Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, P.R.China)

机构地区：[1]广州医科大学附属第一医院放射科,广东广州510120

出　　处：《医学影像学杂志》2020年第4期569-573,共5页Journal of Medical Imaging

摘　　要：目的探讨原发性纵隔混合型生殖细胞瘤(mixed germ cell tumor,MGCT)的影像学表现及临床特征。方法回顾性分析经病理确诊的7例纵隔MGCT的临床、影像及病理资料。7例患者行胸部CT平扫及增强检查,5例同时行PET/CT检查。结果7例病灶均表现为分叶状或类圆形囊实性肿块,病灶最大径9.0~20.1cm,中位数15.7cm;增强动脉期瘤内均见强化迂曲血管影,静脉期血管影增多,瘤灶实性部分强化较动脉期明显,不均匀渐进性强化。5例PET/CT检查病灶最大标准化摄取值(SUVmax)范围约5.0~8.3,平均6.7±1.5。结论青少年男性、增强动静脉两期血管影逐渐增多、瘤灶实质不均匀渐进性强化、瘤灶血供丰富却不同程度囊变及坏死、18F-FDG高代谢的前纵隔囊实性肿块,有助于提示MGCT的诊断。Objective To investigate the imaging findings and clinical features of the mixed germ cell tumor(MGCT)of the mediastinum.Methods The clinical,imaging and pathological data of 7 patients with MGCT,who were proved by surgery or biopsy pathology,were retrospectively analyzed.All patients underwent CT scan without contrast injectioncontrast and enhanced CT scan,5 patients also underwent PET/CT scan.Results All lesions in 7 cases presented as lobulated or quasi-circular cystic-solid masses.The maximum diameter of the tumor ranged from 9.0 to 20.1 cm(median 15.7 cm).Enhancement of tortuous vessels was seen in the arterial phase,and vessels increased in the venous phase.Solid partial enhancement was more obvious than arterial phase,showing asymmetric progressive enhancement.5 cases with PET/CT scan demonstrated avid FDG uptake with SUV ranged from 5.0 to 8.3(mean 6.7±1.5).Conclusion Adolescent males,and that mediastinal soild cystic mass of which enhancement of tortuous vessels was seen in the arterial phase,and vessels increased in the venous phase,solid partial enhancement was more obvious than arterial phase and showing asymmetric progressive enhancement,lesion blood was abundant but massive necrosis and cystic degeneration supply can suggest the diagnosis of MGCT.

关 键 词：纵隔肿瘤 混合性生殖细胞肿瘤 体层摄影术 X线计算机 正电子发射型体层摄影术 

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