儿童和青少年基底节区生殖细胞瘤的临床与影像学特点  

Clinical and imaging features of basal ganglia germinoma in children and adolescents

作　　者：曹郴宁 胡石腾[2] 罗冉[1] 蒋玲[2] 唐琼梅 王月红[3] Cao Chenning;Hu Shiteng;Luo Ran;Jiang Ling;Tang Qiongmei;Wang Yuehong(Department of Radiology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Department of Radiology,NO.1 People′s Hospital of Chenzhou,Chenzhou 423000,China;Department of Ultrasound,NO.1 People′s Hospital of Chenzhou,Chenzhou 423000,China)

机构地区：[1]上海交通大学医学院附属新华医院放射科,上海200092 [2]郴州市第一人民医院影像医学中心,郴州423000 [3]郴州市第一人民医院超声医学中心,郴州423000

出　　处：《中国医师杂志》2022年第1期73-78,共6页Journal of Chinese Physician

摘　　要：目的探讨儿童和青少年基底节区生殖细胞瘤的临床表现与影像学特点,以提高该病的早期诊断准确性。方法回顾性分析上海交通大学医学院附属新华医院2010年1月至2019年12月收治的10例手术病检或诊断性放疗确诊的基底节区生殖细胞瘤的临床症状及影像学表现。结果男9例,女1例,年龄5~15岁,中位年龄10.5岁。肢体乏力或轻度偏瘫10例,头痛呕吐1例,锥体外束征1例。CT检查9例,肿瘤呈高密度5例、混杂密度4例,灶内钙化3例。常规MRI检查10例,T1WI:低信号5例、稍低信号3例、等低信号1例、等稍低信号1例;T2WI:高信号3例、稍高信号5例、高低混杂信号2例;T2液体衰减反转恢复序列(T2FLAIR):低信号1例、稍高信号2例、等高信号1例,高信号5例、高低混杂信号1例;磁共振弥散成像(DWI):低信号2例、等信号1例、等稍高信号1例,稍高信号4例、高信号2例;功能成像磁敏感加权成像(SWI)1例:低信号1例;MRI增强10例:无强化2例,轻度强化5例,中度/明显强化3例,强化方式可见斑点状、斑片状、团块状、环状强化;功能成像磁共振血管成像(MRA)2例:1例患侧大脑中动脉纤细,分支动脉较对侧少,1例未见明显异常;PET-CT 2例:2例患侧蛋氨酸(MET)代谢明显增高。结论儿童与青少年基底节区生殖细胞瘤好发于男性,肢体乏力或轻度偏瘫为主要症状。影像学表现具有一定特征性。影像学表现结合相关临床资料,可以提高基底节区生殖细胞瘤早期诊断准确率。Objective To investigate the clinical and imaging features of basal ganglia germinoma in children and adolescents,so as to improve the accuracy of early diagnosis.Methods The clinical symptoms and imaging findings of 10 cases of basal ganglia germinoma diagnosed by surgical examination or diagnostic radiotherapy in Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University from January 2010 to December 2019 were analyzed retrospectively.Results There were 9 males and 1 female,aged from 5 to 15 years,with an average age of 9.7 years.There were 10 cases of limb weakness or mild hemiplegia,1 case of headache and vomiting,and 1 case of extrapyramidal tract sign.There were 9 cases of computed tomography(CT)examination,5 cases of high density,4 cases of mixed density,and 3 cases of intrafocal calcification.10 cases of routine magnetic resonance imaging(MRI)examination,MR T1-weighted imaging(T1WI):5 cases of low signal,3 cases of slightly low signal,1 case of equal low signal,1 case of equal slightly low signal;MR T2-weighted imaging(T2WI):3 cases of high signal,5 cases of slightly high signal,2 cases of high and low mixed signal;T2 fluid attenuated inversion recovery(T2FLAIR):1 case of low signal,2 cases of slightly high signal,1 case of iso-high signal,5 cases of high signal,1 case of high and low mixed signal;Diffusion weighted imaging(DWI):2 cases of low signal,1 case of equal signal,1 case of equal slightly high signal,4 cases of slightly high signal,2 cases of high signal;1 case of functional imaging susceptibility-weighted imaging(SWI):1 case of low signal;10 cases of MRI enhancement:2 cases of no enhancement,5 cases of mild enhancement,3 cases of moderate/obvious enhancement,and the enhancement methods can be seen in spot,patch,mass and ring enhancement;Functional imaging magnetic resonance angiography(MRA)in 2 cases:1 case had slender middle cerebral artery,fewer branch arteries than the opposite side,and 1 case showed no obvious abnormality;2 cases of positron emission(PET)-CT:the metabolism

关 键 词：生殖细胞瘤 基底神经节 脑肿瘤 磁共振成像 儿童 青少年 

分 类 号：R739.41[医药卫生—肿瘤]