摘要
目的:探讨松果体区实性肿瘤的CT及MRI影像特点及诊断要点。方法:搜集本院43例松果体区实性肿瘤的CT及MRI资料,生殖细胞瘤经手术病理及临床放疗后随访证实,其余病例均经手术病理证实。结果:生殖细胞瘤25例(手术病理证实18例,临床放疗后随访证实7例);松果体实质细胞肿瘤10例;神经上皮源性肿瘤4例;脑膜瘤4例。生殖细胞瘤表现为圆形或类圆形肿块,边界清楚,密度/信号均匀,CT呈等或稍高密度,钙化的松果体被肿瘤包裹或位于肿瘤周边;MRI呈T_1WI等低信号,T_2WI等/稍低信号,增强扫描明显均匀强化。松果体细胞瘤表现为松果体区圆形或类圆形、浅分叶、边界清楚的肿块,CT呈稍高密度,MRI呈T_1WI低信号,T_2WI稍高信号,增强扫描一般均匀强化,部分不均匀强化。松果体母细胞瘤肿瘤呈深分叶状,形态不规则,肿瘤内部可见出血、囊变、坏死,增强扫描明显不均匀强化,中间分化的松果体实质细胞瘤影像学表现介于松果体细胞瘤及松果体母细胞瘤之间。脑膜瘤呈圆形或类圆形,形态规则,边界清楚,与周围组织分界清楚,CT呈稍高密度,T_1WI呈等信号,T_2WI呈等稍低信号,信号/密度均匀,增强扫描明显均匀强化,并可见"脑膜尾征"。结论:松果体区域组织成分较复杂,肿瘤种类较多,影像学表现多种多样;需结合影像学表现(肿瘤形态、边界、其与周围组织关系、强化特点)及临床资料(患者年龄、性别、实验室检查等)综合考虑做出诊断。
Objective:The aim of this study was to explore the value of CT and MRI in diagnosis of the solid tumors of the pineal region and the key diagnostic points. Methods:The CT and MRI data of 43 cases with solid tumors in the pineal region of our hospital were collected.The germ cell tumor was confirmed by surgical pathology and follow-ups after clinical radiotherapy.The other tumors were confirmed by surgical pathology. Results:Of the 43 cases,there were 25 cases of germinoma (18 were proved by surgical pathology;7 cases by radiotherapy),10 pineal parenchymal tumor,4 neuroepithelial tumor and 4 meningioma.Germinoma presented as round or round-like mass with clear margin,even signal/density,equal or slightly high density on CT.Calcified pineal gland was encapsulated or located around the tumor.MRI showed low signal on T 1WI,and slightly low signal on T 2WI.Pineal cell tumors are round or round-like too,superficially lobulated and well-defined masses;which had slightly high density on CT and low signal on T 1WI and slightly high signal on T 2WIon MRI.The masses generally showed as even enhancement and partial uneven enhancementon enhanced scan.Pineal blastoma tumors were deeply lobulated and irregular in shape.Hemorrhage,cystic degeneration and necrosis were seen in the tumors with obviously uneven enhancement.The imaging manifestations of intermediate differentiated pineal parenchymal cell tumors werebetween pineal cell tumors and pineal blastoma.Meningiomas were of regular round shape with clear boundary with surrounding tissues,and of slightly high-density on CT,medium signal on T 1WI,slightly low signal on T 2WI,homogeneous signal/density,and remarkably homogeneous enhancement on contrast-enhanced scan,and "meningeal tail sign" was seen. Conclusion:The pineal region has complex tissue components,tumors happened in this region are of many categories of cells with a variety of imaging features.A diagnosis must be combined with imaging features (tumor morphology,border,relationship with surrounding tissue,enhanced cha
作者
张静
郑君惠
黄飚
ZHANG Jing;ZHENG Jun-hui;HUANG Biao(Second Clinical Medical College of Southern Medical University,Guangzhou 510515,China)
出处
《放射学实践》
北大核心
2019年第3期270-276,共7页
Radiologic Practice
关键词
松果体区
脑肿瘤
体层摄影术
X线计算机
磁共振成像
Pineal region
Brain neoplasms
Tomography,X-ray computed
Magnetic resonance imaging
