摘要
目的研究基底节区生殖细胞瘤的CT、MRI及氢质子磁共振波谱(1H-MRS)表现,以提高对该病的诊断水平。资料与方法搜集6例经活检或手术病理证实的生殖细胞瘤,全部病例均行MRI平扫加增强扫描,其中4例加做CT平扫及增强扫描,3例行MRS检查,5例行追踪复查。对其影像学表现进行回顾分析。结果CT表现:2例点状钙化,2例囊实性肿块。MRI表现:3例为肿块状,3例为片状(复查时示肿块状)。T1WI上病灶呈低或等信号,T2WI呈高信号。增强后3例呈环状强化,2例轻度片状强化,1例显著均匀强化。3例呈片状肿瘤者行MRS检查,首诊时胆碱(choline,Cho)、氮-乙酰天门冬氨酸(N-acetyl aspartate,NAA)、肌酸(creatine,Cr)峰的形态大致正常,2例NAA/Cho和NAA/Cr下降,并见脂质(Lip)/乳酸(Lac)峰,1例复查时Cho峰升高,NAA、Cr峰降低。结论CT、MRI在基底节区生殖细胞瘤的诊断中具有一定的局限性,1H-MRS发现NAA/Cho、NAA/Cr比值下降和出现Lip/Lac峰,建议临床进行穿刺活检以早期诊断。
Objective To study the CT,MRI and proton magnetic resonance spectroscopy（1H MRS）findings of primary basal ganglia germinoma and to improve the diagnostic accuracy of the disease.Materials and Methods 6 patients with biopsy-or surgery-proven germinoma arising from basal ganglia were included.MRI was performed in all patients,CT in 4 patients and MRS in 3 patients.Follow-up MRI results were available in 5 out of 6 patients.The CT,MRI and MRS findings were analyzed retrospectively.Results On CT,calcification was found in 2 cases and solid mass with cystic change in other 2 cases.On MRI,3 tumors were mass-like and 3 were initially patchy in appearance（all became mass-like on follow-up imaging scan）.The tumors demonstrated hypo-and isointensity on T1-weighted images and hyper-intensity on T2-weighted images.After contrast injection,ring-like（3）,patchy and mild（2）,and homogeneous and intense（1）patterns were observed.For the three patients presented with patchy tumors,the level of Cho、NAA and Cr was normal.Decreased NAA/Cho,NAA/Cr ratios and lipid/lactate peak were detected in 2 cases compared to contra-lateral normal side.Abnormally increased Cho and decreased NAA and Cr were noted in one tumor when follow-up.Conclusion There are some limitations of MRI and CT in diagnosis of germinomas arising from basal ganglia.When decreased NAA/Cho,NAA/Cr ratios and lipid/lactate peak were detected in ^1H-MRS,biopsy should be suggested to get accuracy diagnosis.
出处
《临床放射学杂志》
CSCD
北大核心
2009年第10期1465-1468,共4页
Journal of Clinical Radiology
关键词
生殖细胞瘤
基底节
磁共振成像
磁共振波谱
Germinoma Basal ganglia Magnetic resonance imaging Magnetic resonance spectroscopy
