鞍区生殖细胞瘤MRI影像分析(附11例报告)

The MRI of sellar germinoma(analysis of 11 cases)

目的:分析鞍区生殖细胞瘤的MRI表现及临床特征。方法:选择经病理或临床实验室检测及试验性治疗证实的11例鞍区生殖细胞瘤患者作为研究对象,结合文献回顾性分析鞍区生殖细胞瘤治疗前MR影像表现。结果:11例患者均表现为垂体柄增粗和垂体后叶正常短T1高信号消失,9例有中枢性尿崩症。MRI图像:T1WI肿瘤呈等信号,但在T2WI上信号不均匀表现为多样性。3例肿瘤延伸入第三脑室并囊变坏死,1例肿瘤沿四脑室及侧脑室播散转移。结论:青少年女性出现的鞍区实性病变,T2上信号不均匀,有显著强化,伴垂体柄增粗,垂体后叶短T1高信号消失,高度提示生殖细胞瘤,影像与临床结合有利于早期诊断,改善生殖细胞瘤预后。

Objective： To analyze the appearance of sellar germinomas by MRI. Methods：Eleven patients with sellar germinoma confirmed by experimental radiotherapy before obtaining histological results or clinical lab test in our hospital were selected as the object of this study. The manifestataions of MR images before treatment were analyzed combined with cor- related documents retrospectively. Results：Thickness of pituitary stalk and absence of the hyperintensity of the posterior pituitary on T1 WI were observed in all eleven cases, and 9 of them displayed central diabetes insipidus. MRI shows germinomas were isointense on T1 WI, but variable and hetrogeneous intensities were exhibited on T2 WI. and 3 of which extended into third ventricle. One of them reveal scattered metastases within the forth and the bilateral ventricles. Conclusion; Solid mass in sellar among female young person, which show hetrogeneous signal intensity on T2 WI, and obvious contrast enhancement, apparent contrast enhancement, accompanied with thickness of pituitary stalk and absence of the posterior pituitary high signal on T1 WI can intensively suggest the diagnosis of sellar germinoma. The accurate and early diagnosis can benefit patients＇ prognosis greatly.