单发脊髓内生殖细胞瘤的临床及磁共振特点（附五例报告）

MRI and clinical features of solitary spinal cord intramedullary germinoma： a report of 5 cases

目的 分析单发的脊髓内生殖细胞瘤的临床特点及MRI表现.方法 回顾性纳入首都医科大学附属北京天坛医院2008年1月至2015年1月经手术及病理学证实的5例单发脊髓生殖细胞瘤患者.5例均行MR平扫及增强检查,分析其临床及MR信号特点.结果 男/女为1/4;年龄为23～47岁,平均（29.6±10.3）岁;病程2～19个月,中位时间为4个月.1例合并Klinefelter综合征,1例10年前鞍区生殖细胞瘤放疗后颅内无复发,1例5年前卵巢畸胎瘤术后无复发.病变累及颈胸段2例,胸腰段3例.病变纵轴长度23～66 mm,平均（40.2±16.4）mm.T1WI表现为等或低信号,T2WI表现为等或高信号,增强后2例均匀强化,3例不均匀强化,4例病变边界不清.3例肿瘤内有囊变,4例病变周围脊髓有水肿,5例病变周围均无脊髓空洞.结论 单发脊髓内生殖细胞瘤影像学表现常无特异性,既往病史、合并先天畸形及实验室检查对于鉴别诊断非常重要.

Objective To analyze the MR imaging appearances and relevant clinical characteristics of solital7 spinal cord intramedullary germinoma. Methods Five patients with intramedullary spinal cord germinoma with pretreatment unenhanced and enhanced MR imaging examinations were identified. The MR imaging examinations for each patient were reviewed by 2 neuroradiologists for various imaging characteristics. Relevant clinical data were obtained. Results The patients included 4 female and 1 male, ranging in age from 23 to 47 years, with a mean age of 29.6 10.3 years. The disease duration was ranged from 2 months to 19 months with a median of 4 months. Three of them are complicated with other diseases, one case was associated with Klinefeher syndrome, one had sellar germinoma chemotherapy ten years ago without any intracranial recurrence, and another underwent ovarian teratoma surgery 5 years ago without recurrence. Two eases involved cervicothoracic spinal cord, and the other 3 cases thoracolumbar. The longitudinal length of spinal germlinomas were 23 N 66 mm with an average of 40. 2 ± 16. 4 mm. The tumors showed iso to hypointensity on T1WI, iso to hyperintensity on T2WI. After contrast administration, 2 cases were enhanced homogenously, the other 3 cases were enhanced inhomogenously. The tumor was ill-defined in 4 cases. Tumoral cysts were seen in 3 cases. Peritumoral edema was found in 4 cases. Sylingohydromyelia was not found in all cases. Conclusion Routine MR imaging demonstrated no specific characteristic of spinal cord germinoma, so correct diagnosis before treatment planning is very difficult, however, the relevant medical history may be helpful for the differential diagnosis.