颅内绒毛膜上皮癌的影像学表现

目的分析颅内绒毛膜上皮癌的影像学表现,提高其诊断符合率。资料与方法回顾性分析4例经病理证实的颅内绒毛膜上皮癌,4例均行MRI头颅平扫和增强扫描,使用Siemens Vision Plus 1.5 T或GE 3.0 SignaExite超导型磁共振扫描仪;2例行CT头颅平扫,1例行CT头颅平扫和增强扫描,采用Somatom Plus 4全身CT扫描机或GE Light Speed 16螺旋CT扫描仪。结果 4例人绒毛膜促性腺激素(HCG)均明显增高。3例颅内原发性绒毛膜上皮癌,均位于松果体区且均为男性;1例颅内继发性绒毛膜上皮癌,发生在脑实质内,为女性。CT扫描呈团块状或分叶状混杂密度影,内可见小点状或斑块状高密度钙化灶;增强扫描肿块呈轻中度强化。MRI呈不均匀混杂T1、T2信号,可见低信号含铁血黄素沉着及钙化,幕上脑室不同程度积水,增强扫描实性部分呈较明显不均匀强化。结论颅内绒毛膜上皮癌易发生肿瘤内出血或肿瘤卒中,结合临床特点及实验室检查可在术前作出较为准确的诊断,但最终确诊仍依靠病理及免疫组织化学。

CT and MRI Diagnosis of Intracranial Choriocarcinoma

Objective To discuss CT and MR imaging findings of intracranial choriocarcinoma,and improve its diagnostic accuracy.Materials and MethodsCT and MRI findings of four cases with intracranial choriocarcinoma proved pathologically were analyzed retrospectively.Plain and enhanced MR scan were performed in all four cases,two cases received plain CT scan and one case received plain and enhanced CT scan.ResultsThe blood HCG level was obviously increased in all the four cases,among them,three cases were young boys with primary intracranial choriocarcinoma occurred in the pineal region,and the other one was adult female with secondary tumor occurred in the parenchyma.The masses demonstrated lump or lobulated mixed density on CT with calcification within the tumor and mild to moderate enhancement.MRI also exhibited masses with inhomogenous signa1 intensity both on T1 and T2WI,hemosiderin and calcification and heterogeneous enhancement can be seen on MRI.ConclusionIntracranial choriocarcinoma is often accompanied with hemorrhage within the tumor.Combining with laboratory examination,correct diagnosis can be made before operation,ultimate diagnosis is depended on the pathological and immunohistochemical results.