儿童混合性生殖细胞肿瘤的CT表现及其临床价值  

CT manifestations and clinical value of mixed germ cell tumors in children

作　　者：刘娇静 聂磊[1] 范晓鸽 康乐乐 贾春阳 时胜利 Liu Jiaojing;Nie Lei;Fan Xiaoge;Kang Lele;Jia Chunyang;Shi Shengli(Department of Medical Imaging,Affiliated Children's Hospital of Zhengzhou University,Henan 450000,China)

机构地区：[1]郑州大学附属儿童医院医学影像科,450000

出　　处：《实用医学影像杂志》2023年第3期210-214,共5页Journal of Practical Medical Imaging

摘　　要：目的总结儿童混合性生殖细胞肿瘤的CT表现,提高对此病的认识及诊断准确率。方法回顾性分析我院经病理结果证实的19例不同部位的混合性生殖细胞肿瘤的CT资料,总结其特点。19例均行CT平扫,15例行增强检查。结果本组病例中18例2种成分混合,1例卵黄囊瘤、成熟性畸胎瘤、胚胎性癌3种成分混合。骶尾部11例,卵巢5例,睾丸1例,纵隔2例。肿物均为囊实性,内部见不同程度的坏死囊变区,10例类圆形,9例不规则分叶状。增强扫描15例实性部分均呈渐进性不均匀强化,14例肿物内部见迂曲增粗血管影。6例淋巴结转移,1例肺转移,6例包绕骶尾骨、伸入椎管,其中2例并骨质破坏。肿瘤标志物甲胎蛋白(AFP)、人绒毛膜促性腺激素(HCG)及乳酸脱氨酶(LDH)升高有助于明确诊断。结论儿童混合性生殖细胞瘤CT表现多样,但仍具有一定特点,结合肿瘤标志物及临床资料,可提高诊断准确率,还可以明确肿瘤范围及有无转移,为临床制定治疗方案及评估预后提供帮助。确诊依赖病理及免疫组化。Objective To summarize the CT findings of mixed germ cell tumors in children and improve the recognition and diagnostic accuracy of this disease.Methods The CT data of 19 cases with mixed germ cell tumors in different parts confirmed by pathology in our hospital were analyzed retrospectively,and their characteristics were summarized.Nineteen cases underwent plain CT scan and 15 cases underwent enhanced CT scan.Results In this group,18 cases were mixed with two ingredients,and 1 case was mixed with yolk sac tumor,mature teratoma,and embryonic carcinoma.There were 11 cases in sacrococcygeal region,5 cases in ovary,1 case in testis and 2 cases in mediastinum.The tumors were cystic and solid,with necrotic and cystic areas of varying degrees in the interior.Ten cases were round,9 cases were irregular lobulated.In contrast enhanced scanning,the solid part of 15 cases showed progressive uneven enhancement,and tortuous and thickened vascular shadows were seen in 14 cases.Lymph node metastasis was found in 6 cases,lung metastasis in 1 case,sacrococcygeal bone wrapping in 6 cases and extending into the vertebral canal,and bone destruction was found in 2 cases.The increase of tumor markers AFP,HCG and LDH was helpful to the diagnosis.Conclusion The CT manifestations of mixed germ cell tumors in children are diverse,but they still have certain characteristics.Combined with tumor markers and clinical data,the accuracy of diagnosis can be improved,and the scope of tumors and whether there is metastasis can also be determined,which provides help for clinical formulation of treatment plans and evaluation of prognosis.The diagnosis depends on pathology and immunohistochemistry.

关 键 词：儿童 混合性生殖细胞肿瘤 X线计算机 体层摄影术 

分 类 号：R730[医药卫生—肿瘤]