原发性颅内绒毛膜癌的影像学表现

目的总结原发性颅内绒毛膜癌(PICCC)的影像学表现,以提高该病影像诊断的正确率。方法回顾性分析经穿刺或手术病理证实的4例PICCC的CT和MRI影像学表现,包括分布和形态、密度、信号特点和强化特征。结果1例PICCC位于松果体区,1例位于鞍上,1例位于基底节区,1例沿侧脑室旁分布。CT平扫以高密度为主,CT值为45~65 HU,病灶内可见钙化和出血,增强扫描呈中等程度或明显强化。MRI平扫呈混杂信号,3例T1WI呈等低信号,1例呈高信号;T2WI呈低信号为主的混杂信号。增强扫描2例呈明显不均匀强化,2例呈花环状强化,1例伴室管膜明显强化。结论PICCC好发于青少年,易合并瘤内出血和钙化,结合血清β-HCG水平升高和临床症状,术前应考虑到PICCC的可能。

Imaging manifestations of primary intracranial choriocarcinoma

Objective To summarize the CT and MRI imaging manifestation of primary intracranial choriocarcinoma(PICCC)in order to improve the correct diagnosis of PICCC.Methods CT and MRI imaging findings of 4 PICCC confirmed by puncture or surgical pathology were retrospectively analyzed,including distribution and morphology,density,signal intensity and enhancement characteristics.Results 1 case was located in the pineal region,1 case in suprasellar region,1 case in basal ganglia and 1 case was distributed along the lateral ventricle.The tumors mainly demonstrated as high density on CT plain scan with CT value of 45-65 HU,and calcification and bleeding can be seen in the lesion,and CT enhanced scan showed moderate and obvious enhancement.PICCCs usually showed miscellaneous signal intensity.3 cases showed hypointensity on T1WI and 1 case showed hyperintensity on T1WI;4 cases showed miscellaneous signal dominated by hypointensity.2 cases demonstrated inhomogeneously obvious enhanced,2 showed ring-like enhanced and 1 accompanied by obvious ependymal enhanced.Conclusion PICCCs often occur in young people and intratumoral bleeding and calcification are easily seen.In combination with elevated serum level ofβ-HCG and clinical symptoms,the diagnosis of PICCC should be considered before operation.