本文選題：腦腫瘤 + 生殖細(xì)胞瘤�。� 參考：《中國臨床醫(yī)學(xué)影像雜志》2017年08期

【摘要】：目的 :探討兒童及青少年顱內(nèi)生殖細(xì)胞瘤的臨床表現(xiàn)及影像學(xué)特點(diǎn),以提高對(duì)本病的認(rèn)識(shí)。方法 :回顧性分析45例經(jīng)病理或隨訪證實(shí)的不同部位顱內(nèi)生殖細(xì)胞瘤患者臨床表現(xiàn)及影像學(xué)的特點(diǎn)。結(jié)果:7例(16%)位于松果體區(qū),均為男性,平均11歲,主要臨床表現(xiàn)為顱內(nèi)高壓(71%),3例行CT平掃,顯示等高密度含鈣化的類圓形腫塊,MRI顯示T_1WI及T_2WI等信號(hào)、DWI等(27%)或稍高(73%)信號(hào)的腫塊,增強(qiáng)后明顯強(qiáng)化。24例(53%)位于鞍區(qū),75%為女性,平均10歲,主要臨床表現(xiàn)為尿崩癥(83%),6例行CT平掃,腫塊顯示為等高密度,但無一鈣化,MRI顯示94%為形態(tài)各異的腫塊,其中36%伴小囊變,實(shí)性部分影像表現(xiàn)類似松果體區(qū)腫瘤,6%僅表現(xiàn)為垂體柄結(jié)節(jié)樣增粗。10例(22%)位于丘腦基底節(jié)區(qū),90%為男性,平均11歲,主要臨床表現(xiàn)為輕偏癱(70%),7例行CT平掃,顯示腫塊實(shí)性部分高密度,57%含鈣化,MRI顯示不規(guī)則的T_1WI及T_2WI等信號(hào)、DWI等(44%)或稍高(56%)信號(hào),增強(qiáng)后中度強(qiáng)化,50%伴囊變或出血,38%伴偏側(cè)腦萎縮。多中心病變占9%,75%為男性,臨床表現(xiàn)與其中某一部位損害類似,影像學(xué)表現(xiàn)也與該部位特點(diǎn)相同。結(jié)論:10~12歲是顱內(nèi)生殖細(xì)胞瘤主要發(fā)病年齡,松果體區(qū)、鞍區(qū)及丘腦基底節(jié)區(qū)為好發(fā)部位,松果體區(qū)及丘腦基底節(jié)區(qū)男性占絕對(duì)優(yōu)勢(shì),不同部位生殖細(xì)胞瘤的臨床及影像學(xué)表現(xiàn)各具特點(diǎn),兩者結(jié)合能提高對(duì)顱內(nèi)生殖細(xì)胞瘤的診斷。
[Abstract]:Objective: to investigate the clinical and imaging features of intracranial germinoma in children and adolescents. Methods: the clinical and imaging features of 45 patients with intracranial germinoma confirmed by pathology or follow-up were retrospectively analyzed. Results in the pineal region of 7 cases, all of them were male with an average age of 11 years. The main clinical manifestations were CT plain scan of intracranial hypertension in 3 cases, showing the mass with T_1WI and T_2WI signals (27%) or slightly higher signal intensity (73). After enhancement, 75% of the women were located in the Sellar area, with an average age of 10 years. The main clinical manifestations were diabetes insipidus, 833% of them were plain CT scan, the mass showed iso-high density, but no calcified MRI showed 94% of the tumors, 36% of which were accompanied with small cystic change. Solid partial imaging was similar to pineal region tumor in 6%. Only 10 cases presented as pituitary stalk nodular thickening. 90% of them were male (mean 11 years old) located in basal ganglia of thalamus. The main clinical manifestations were 70% of hemiplegia and 7 cases of CT plain scan. MRI showed irregular T_1WI and T_2WI signals (44) or slightly higher (56%). After enhancement, 50% of the lesions were moderately enhanced with cystic degeneration or hemorrhage and 38% with hemiatrophy. Multicentric lesions accounted for 75% of the male lesions. The clinical manifestation was similar to that of one of the lesions, and the imaging features were the same. Conclusion the age of 12 years old is the main age of intracranial germinoma. The pineal region, Sellar region and basal ganglia of thalamus are the predilection sites, and the pineal and thalamic basal ganglia are the dominant male. The clinical and imaging features of germinoma are different, and the combination of the two can improve the diagnosis of intracranial germinoma.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院放射科;
【分類號(hào)】：R445.2;R739.4

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