儿童中枢神经系统非典型畸胎瘤/横纹肌样肿瘤CT和MRI表现特征分析  

Analysis of CT and MRI Features of Atypical Teratoma/Rhabdomyoid Tumors in the Central Nervous System of Children

作　　者：邹明 丁培源 龚云燕 蔡建国 邱健 黄炳乐 薛周 李文华 ZOU Ming;DING Pei-yuan;GONG Yun-yan;CAI Jian-guo;QIU Jian;HUANG Bing-le;XUE Zhou;LI Wen-hua(Department of Medical Imaging,Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences,Shanghai 202150,China;Department of Radiology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海健康医学院附属崇明医院医学影像科,上海202150 [2]上海交通大学医学院附属新华医院放射科,上海200092

出　　处：《中国CT和MRI杂志》2025年第3期6-8,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨儿童中枢神经系统(CNS)非典型畸胎瘤/横纹肌样瘤(AT/RT)的CT和MRI表现特征。方法对26例经病理证实的AT/RT患者的临床和MRI表现进行回顾性分析,记录病变的部位、大小范围、形态、密度、钙化和T1WI、T2WI及弥散加权成像(DWI)信号特点、表观弥散系数(ADC)值及强化特征进行分析研究。结果26例中,21例肿瘤位于幕上,5例位于幕下。肿块大小从2.01×2.32cm到4.80×5.91cm。26例肿块形态上分为以下四型:1.囊实型12例,2.实质型7例,3.实质性肿块伴中央疤痕型5例,4.不规则环状肿块型2例。肿瘤实质部分CT扫描呈高密度(钙化12例,占46.2%),T1WI呈等或略低信号、T2WI呈等或略高低混合信号(肿块内伴有疤痕或索条样低信号)和DWI呈高信号,ADC值测量范围为0.37-1.15×10^(-3)mm^(2)/s,平均ADC值为0.71±0.11×10^(-3)mm^(2)/s。增强后肿块的实性部分呈非均匀性轻-明显强化,其中轻度强化者9例,中度到明显强化者17例。结论AT/RT多呈囊实性或实性不规则肿块,其内于T2WI显示疤痕样或星芒状低信号,肿瘤实性部分CT呈高密度,增强后肿块呈轻-明显非均匀性强化伴有较低的ADC值是其诊断特征。Objective To explore CT and MRI features of atypical teratoma/rhabdomyoid tumors(AT/RT)in the central nervous system(CNS)of children.Methods The clinical,CT and MRI data of 26 patients confirmed with AT/RT were analyzed retrospectively.The location,size,morphology,density,calcification,T1WI,T2WI,and diffusion-weighted imaging(DWI)signal characteristics,apparent diffusion coefficient(ADC)values,and enhancement pattern were recorded.Results 26 patients,21 were located in supratentorial and 5 were infratentorial regions.The size of the mass ranges from 2.01×2.32cm to 4.80×5.91cm.They were classified into four types:1.Cystic-solid type in 12 cases,2.solid type in 7 cases,3.solid mass with central scar type in 5 cases,and 4.irregular circular mass type in 2 cases.The CT scan of the tumor solid parenchyma showed high density(calcification in 12 cases,46.2%).The solid component of the mass was equal or slightly low signal on T1WI,equal or slightly mixed signal on T2WI(with central scar or internal low signal),and high signal on DWI.The ADC value of the tumors ranged from 0.37 to 1.15×10^(-3)mm^(2)/s with a mean value of 0.71±0.11×10^(-3)mm^(2)/s.The solid component of the mass showed non-uniformly slightly enhancement in 9 cases and moderate to significant enhancement in 17 cases.Conclusion AT/RT often presents as cystic or irregular solid masses within scar or strip-like low signal on T2WI.The solid component of the mass was high density on CT scan and shows mild to significant non-uniform enhancement with lower ADC values.

关 键 词：中枢神经系统 非典型畸胎瘤/横纹肌样瘤 CT MRI 儿童 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]