51例颅内生殖细胞瘤的薄层增强MR及临床特征分析

目的:探讨颅内生殖细胞瘤薄层增强MR及临床特征,以提高诊断准确性。方法:回顾性分析51例颅内生殖细胞瘤薄层增强MR及临床资料。按部位分为A组(鞍区+松果体区)17例、B组(侧脑室周围)22例、C组(基底节+丘脑区)12例。对三组患者的影像特征及临床资料(包括年龄、性别、形状、生长方式、边界、强化方式、强化程度、椒盐征、伴囊变)进行比较分析。结果:三组的年龄分别为:A组(18.24±4.74)岁,B组(21.68±7.89)岁,C组(19.92±10.61)岁,差异无统计学意义(P=0.395)。性别男/女比例分别为:A组(9/8),B组(18/4),C组(12/0),P=0.010。形状(团块状/不规则状)比例分别为:A组(16/1),B组(22/0),C组(0/12),P<0.001。生长方式(肿块型/蔓延型)比例分别为:A组(17/0),B组(0/22),C组(12/0), P<0.001。边界(清楚/不清楚)比例分别为:A组(16/1),B组(20/2),C组(9/3),P=0.254。强化方式(均匀/不均匀)比例分别为:A组(14/3),B组(9/13),C组(2/12),P=0.001。强化程度(轻度/明显)比例分别为:A组(16/1),B组(19/3),C组(11/1),P=0.708。椒盐征(有/无)比例分别为:A组(10/7),B组(13/9),C组(5/7),P=0.574。伴囊变(有/无)比例分别为:A组(7/10),B组(18/4),C组(8/4),P=0.031。三组的性别、形状、生长方式、强化方式、伴囊变比例差异有统计学意义(P<0.05),三组的边界、强化程度、椒盐征差异无统计学意义(P>0.05)。结论:颅内生殖细胞瘤患者的性别、病变形状、生长方式、强化方式、伴囊变表现具有部位特征性,患者的年龄、病变边界、强化程度、椒盐征不同部位具有共同性,熟悉颅内生殖细胞瘤的MR及临床特征,可以提高诊断准确性。

Thin-layer Enhanced MR Image Analysis of 51 Cases of Intracranial Germinomas

Objective The thin-layer enhanced MR findings of intracranial germinomas,which were analyzed to improve the diagnostic accuracy.Methods A retrospective analysis of 51 cases of intracranial germinomas thin-layer enhanced MR imaging data.Divided into parts by group A(saddle region+pineal gland region),group B(around the lateral ventricle),group C(basal ganglia+thalamus region).Statistical analysis of the image characteristics and clinical data of three groups of cases(including age,gender,shape,growth pattern,border,enhancement method,degree of enhancement,pepper and salt sign,and cystic changes).Other data were tested by R*C contingency table chi-square.Results Age,18.24±4.737 years in group A;21.68±7.888 years in group B;19.92±10.613 years in group C,P=0.395.Gender(male:female),group A(9:8),group B(18:4),group C(12:0),P=0.010.Shape(mass:irregular),group A(16:1),group B(22:0),group C(0:12),P<0.001.Growth pattern(lump type:spread type),group A(17:0),group B(0:22),group C(12:0),P<0.001.Boundary(clear:unclear),group A(16:1),group B(20:2),group C(9:3),P=0.254.Strengthening method(uniform:uneven),group A(14:3),group B(9:13),group C(2:12),P=0.001.Degree of enhancement(mild:obvious),group A(16:1),group B(19:3),group C(11:1),P=0.708.Salt and pepper sign(yes:no),group A(10:7),group B(13:9),group C(5:7),P=0.574.Concomitant cystic changes(yes:no),group A(7:10),group B(18:4),group C(8:4),P=0.031.There were statistically significant differences in gender,shape,growth pattern,strengthening pattern and concomitant cyst changes(P<0.05).There was no statistically significant difference in age,border,degree of strengthening as well as salt and pepper sign(P>0.05).Conclusion Patients with intracranial germ cell tumor have sex,lesion shape,growth pattern,enhancement pattern and cystic changes.They are characteristics of the patient's age,lesion boundary,degree of enhancement and different parts of the pepper-salt sign.They are familiar with intracranial germ cell tumors.MR and clinical features can improve diagnostic accuracy.