基底节生殖细胞瘤的增强磁共振表现分析

Analysis of enhaned magnetic resonance imaging findings of the basal ganglia germinoma

目的 总结基底节生殖细胞瘤的临床特征及增强MRI表现,并探讨其与大脑脚萎缩的关系。方法选取2010年9月至2021年4月解放军总医院第六医学中心经手术或立体定向穿刺活检病理证实的基底节生殖细胞瘤患者39例,回顾分析其临床和影像学资料,MRI增强表现特点及其与大脑脚萎缩的关系。结果 39例患者中男性33例,占84.6%,平均年龄为16.2岁;临床表现以偏瘫为主,占71.8%(28/39)。31例单侧病灶,8例双侧病灶。24个结节状强化病灶中5个出现同侧大脑脚萎缩,占20.8%;12个斑片状强化病灶中5个出现同侧大脑脚萎缩,占41.7%;11个无强化病灶中5个出现同侧大脑脚萎缩,占45.5%。不同病灶强化方式的大脑脚萎缩发生率比较,差异无统计学意义(P>0.05)。结论 基底节生殖细胞瘤增强MRI表现多种多样,大脑脚萎缩是其重要影像征象;大脑脚萎缩发生率与其强化方式无关,可能与内囊后肢受累程度有关。

Objective To summarize the clinical features and enhanced magnetic resonance imaging(MRI) findings of the basal ganglia germinoma, and to explore its relationship with cerebral peduncle atrophy. Methods A total of 39patients with basal ganglia germinoma pathologically confirmed by surgical or stereoscopic needle biopsy from September 2010 to April 2021 in the Sixth Medical Center of PLA General Hospital were selected. The clinical and imaging data, MRI enhancement and its relationship with cerebral peduncle atrophy were retrospectively analyzed. Results A total of 33 in 39cases were male(84.6%), with an average age of 16.2 years. Hemiplegia was the main clinical manifestation, accounting for 71.8%(28/39). There were 31 cases with unilateral lesions and eigh cases with bilateral lesions. Ipsilateral cranial and cerebral peduncle atrophy was found in five of 24 nodular enhancement lesions(20.8%). Ipsilateral cerebrum and cerebral peduncle atrophy was found in five of 12 patchy enhanced lesions(41.7%). Ipsilateral cranial and cerebral peduncle atrophy was found in five of the 11 unenhanced lesions(45.5%). There was no significant difference in the incidence of cerebral peduncle atrophy with different intensification methods(P>0.05). Conclusions The enhancement MRI findings of basal ganglia germinoma are various, and the cerebral peduncle atrophy is an important imaging sign. There is no correlation between the occurrence rate of atrophy of the cerebral peduncle and the enhanced pattern of the lesion, and may be correlated with involvement of the posterior limb of the internal capsule.