儿童骶尾部生殖细胞肿瘤的MSCT及MRI表现

MSCT and MRI findings of children with sacrococcygeal germ cell tumors

目的分析儿童骶尾部生殖细胞肿瘤(GCTS)的MSCT及MRI特点,进一步提高对本组疾病的认识。方法选取河南省儿童医院2013年9月至2019年10月经手术病理证实的GCTS患者14例,均行MSCT扫描,其中8例行MRI扫描,结合临床表现及实验室结果分析GCTS的MSCT与MRI特点。结果本组14例均为单发,包括7例成熟畸胎瘤(MT),3例不成熟畸胎瘤(IT),3例卵黄囊瘤(YST),1例混合性生殖细胞瘤(MGCTS);MT呈囊性或囊实性,伴脂肪及钙化,平扫密度/信号混杂,增强扫描实性成分均匀强化;IT实性成分为主,伴少量脂肪,增强后不均匀强化,血清甲胎蛋白(AFP)升高;YST呈实性或囊实性,MSCT平扫稍低或混杂密度,MRI平扫T1WI等低、T2WI等高信号,DWI呈高信号,增强后明显强化,1例伴迂曲血管,AFP明显升高;GCTS呈囊实性,平扫密度/信号混杂,增强后均匀强化。结论儿童骶尾部GCTS以MT多见,其MSCT及MRI表现多样化,部分肿瘤具有一定特点,结合AFP升高有助于GCTS的诊断及鉴别。

Objective To analyze the MSCT and MRI characteristics of children with sacrococcygeal germ cell tumors(GCTS),and to further improve the understanding of this group of diseases.Methods The imaging data of 14 patients surgically diagnosed with GCTS in Henan Children's Hospital were collected.All the 14 patients underwent MSCT scan,and 8 of which underwent MRI scan.The MSCT and MRI characteristics of GCTS were analyzed based on clinical manifestations and laboratory results.Results All the 14 cases got single tumor,including 7 mature teratoma(MT),3 immature teratoma(MT),3 yolk cystic tumors(YST),and 1 mixed germ cell tumor(MGCTS).MT was cystic or solid,with fat,calcification,mixed density and signal on plain scan,and uniform enhancement of solid components on enhanced scan.IT got solid components,accompanied by a small amount of fat,uneven strengthening after the enhancement,and increased serum alpha fetoprotein(AFP).YST was solid or cystic solid;its MSCT plain scan was slightly lower or had mixed density;its MRI plain scan got iso-low T1WI and iso-high T2WI signals,with high DWI signal and significant enhancement;1 case had tortuous vessels,with an significant increase in AFP.GCTS were solid,with mixed plain scan density/signal and uniform enhancement after enhancement.Conclusion The GCTS of sacrococcyx in children are mostly MT;the MSCT and MRI manifestations are diverse;and some tumors have certain characteristics.The combination of AFP elevation is helpful for the diagnosis and differentiation of GCTS.