摘要
目的 总结纵隔生殖细胞瘤 (GCT)的断面影像表现特征。材料与方法 回顾分析 61个经手术病理证实的纵隔GCT(畸胎类 5 1个 ,非畸胎类 10个 )的断面影像资料 (CTn =5 7,MRIn =8)。对肿瘤进行影像分型 ,重点观察肿瘤部位、大小、内部密度及周围结构关系 ,与手术及病理所见对照 ,比较畸胎类与非畸胎类肿瘤的影像特征。结果 61个肿瘤的病理类型为 :成熟畸胎瘤 44个 ,成熟畸胎瘤恶变 1个 ,不成熟畸胎瘤 4个 ,畸胎瘤合并精原细胞瘤、内胚窦瘤各 1个 ;非畸胎类GCT 10个。肿瘤位于前纵隔占95 .1%。最大径为 4～ 3 1cm ,平均 10 .6cm。影像学分型为 :Ⅰ型 ,单房囊性 (n =2 6) ;Ⅱ型 ,主囊腔边缘有单个或多个小房 (n =8) ;Ⅲ型 ,不规则复合多房囊性 (n =12 ) ;Ⅳ型 ,软组织肿物中含多个小囊区 (n =8) ;Ⅴ型 ,软组织肿物 (n =7)。Ⅰ～Ⅲ型中 ,畸胎类占98.0 % ,其中 ,Ⅰ、Ⅱ型中成熟畸胎瘤占 94.4%。 90 %非畸胎类肿瘤为Ⅳ、Ⅴ型。 5 1个畸胎类肿块中检出脂肪、钙化、水样及软组织密度分别为 74.5 %、5 1.0 %、92 .2 %和 10 0 % ,含 4种密度的肿块 2 2个 ,占 43 .1% ,见于各种类型畸胎瘤。非畸胎类肿瘤中无 1例检出脂肪或钙化。结论 畸胎类肿瘤有囊性成分为主及多种密度混杂的特征 ,其中 ,Ⅰ、Ⅱ型肿块绝大多数为?
Objective To characterize the cross sectional imaging features of mediastinal germ cell tumors (GCT).Materials and Methods CT (n=57) and/or MRI (n=8) scans of 61 cases with pathologically proved mediastinal GCT were retrospectively reviewed. The location, size internal density of the tumor and its relationship with adjacent structures as well as image pattern were analyzed. A comparison was made with the surgical and pathological results. The imaging features of teratomatous GCT were compared with non teratomatous GCT.Results The pathological classification of 61 tumors was as follows: mature teratoma (n=44), mature teratoma with malignant transformation (n=1), immature teratoma(n=4), immature teratoma mixed with serminoma (n=1) or endodermal sinus tumor (n=1), and non teratomatous GCT (n=10). 95.1% of the tumors were located in the anterior mediastinum with maximal dimension of 4～31 cm (mean=10.6cm). Based on the imaging features, the tumors were classified into the following five patterns. Type 1: unilocular cyst (n=26); Type 2: cystic mass with a dominant cyst and some small peripheral loculi (n=8); Type 3: irregular multilocular complex cystic mass (n=12); Type 4: solid mass with small cystic areas (n=8); Type 5: solid mass (n=7). Of type 1, 2 and 3, 98% were teratomas, and 94.4% masses in type 1 and 2 were mature teratomas. Of non teratomatous GCT 90% were in type 4 or 5. In 51 teratomas, fat (74.5%), calcification (51.0%), fluid (92.2%) and soft tissue densities (100%) could be seen. 22 masses (43.1%) had all the above four contents. Neither fat nor calcification was detected in 10 non teratomatous GCT.Conclusion A cyst dominated mass with three or more different densities should be considered as the characteristics of teratomas. Most masses of type 1 and 2 are mature teratoma. Any kind teratoma can be revealed as type 3 or 4. Non teratomatous GCTs usually present as solid dominatedmass without fat or calcifi cation, and differentiation with other mediastinal malignant tumors may be difficult. CT is the best choice for revealing GCT.
出处
《临床放射学杂志》
CSCD
北大核心
2000年第9期545-550,共6页
Journal of Clinical Radiology
关键词
纵隔肿瘤
纵隔生殖细胞瘤
CT
磁共振成像
Mediastinal neoplasm Germ cell Diagnosis Tomography
X ray computed MRI
