低场磁共振成像对卵巢巧克力囊肿与囊性畸胎瘤鉴别诊断价值的研究

目的 探讨低场磁共振成像(MRI)在卵巢巧克力囊肿与囊性畸胎瘤临床鉴别诊断中的价值.方法 回顾性分析经手术及病理证实的卵巢巧克力囊肿22例,囊性畸胎瘤13例,分析各自的MRI表现特点.结果 22例巧克力囊肿术前诊断正确19例,其中3例术前诊断为囊性畸胎瘤,MRI诊断符合率86％(19/22);13例囊性畸胎瘤术前诊断正确12例,1例术前判断为巧克力囊肿,符合率92％(12/13).所有巧克力囊肿和畸胎瘤病例在SET1WI序列下均可见到病灶内高信号区.当使用短时间反转恢复序列(STIR)脂肪抑制序列时,所有高信号区可见不同程度信号减低;当使用GRE同、反相位T1加权成像时,畸胎瘤内的T1WI高信号病灶在反相位图像上会出现明显信号减低区,而巧克力囊肿不会出现信号减低区.结论 卵巢巧克力囊肿与囊性畸胎瘤MRI诊断准确性较高.使用GRE同、反相位T1加权成像对两者的鉴别诊断有特殊价值.     

Giant epignathus with intracranial teratoma in a newborn infant

A male newborn infant with a giant epignathus associated with intracranial teratoma and obstructive hydrocephalus detected antenatally is reported. Only 4 similar cases have been reported in the literature. This disorder is uniformly lethal. We believe this is the first reported case of epignathus with congenital intracranial teratoma diagnosed antenatally by ultrasonography.     

Fat-fluid level in pleural effusion as a complication of a mediastinal dermoid: CT characteristics

The CT findings in a 24-year-old woman with acute chest symptoms revealed excess mediastinal soft tissue and a fat-containing cavity. A fat-fluid level in a pleural effusion suggested preoperatively the diagnosis of mediastinal teratoma, which had leaked into the pleural space.     

Fast magnetic resonance imaging in steady-state precession (true FISP) in the prenatal diagnosis of a congenital brain teratoma

Teratomas are the most common congenital intracranial tumor. Although fetal magnetic resonance (MR) imaging is becoming more popular for prenatal diagnosis, only 2 cases of congenital intracranial teratoma have been reported, and these cases relied on half-Fourier single-shot turbo spin echo (HASTE) imaging. We report the first known case of congenital intracranial teratoma diagnosed by means of a fast imaging in steady-state precession (true FISP) MR sequence. True FISP can be obtained in almost 20 seconds and provides superior contrast resolution compared with HASTE.     

Retroperitoneal teratoma in children. Apropos of 2 cases

Retroperitoneal teratoma is infrequent (5% of all teratomas). The diagnosis is usually made within the first year of life. Two cases are reported. Case n. 1 is typical of mature benign teratoma with teeth, fat and water densities visible on the plain film of the abdomen. Cases n. 2 a malignant partly ossified immature teratoma. The ossification is in continuity of a congenital block of vertebral bodies L2 and L3; this association has not been reported in the literature. CT in both cases was contributive for delineation of the tumor but did not help to answer the question of malignancy or not; foeto-protein remains the only test to do that discrimination.     

CT对卵巢良性囊性畸胎瘤的诊断价值(附21例分析)

目的：探讨卵巢良性囊性畸胎瘤的CT表面特点及其诊断价值。方法：分析21例经手术病理证实的卵巢成熟性囊性畸胎瘤的CT及B超资料，讨论CT表现特点与病理的关系。结果：21例囊性畸胎瘤均显示脂肪密度区。11个“浮球征”，9个脂液平面，10个囊壁钙化呈点状、条块状，4个分房间隔内钙化，2个囊内骨化影和软组织混杂密度影,3个未见钙化影。5例发生蒂扭转。结论：CT能显示良性囊性畸胎瘤的特殊表现，反映其病理特点。     

卵巢畸胎瘤的MRI诊断价值

目的：探讨卯巢畸胎瘤的MRI征象特点及其诊断价值。方法：搜集经手术病理证实的12例卵巢畸胎瘤的MRI资料进行回顾性分析。结果：12例卵巢畸胎瘤中,左侧9例,右侧3例,最大直径13．8cm,9例为圆形或椭圆形,3例为不规则形。10例见脂质信号,6例见明显的双低钙质信号。11个良性者5例显示壁结节,2例实性肿块,1例恶性者信号欠均匀,并有腹膜转移、腹腔积液。结论：对于发生于卵巢的肿瘤,含有脂质的双高信号或钙质的双低信号考虑为卵巢畸胎瘤。     

卵巢畸胎瘤的CT表现

目的研究卵巢畸胎瘤的CT表现.方法经病理证实卵巢畸胎瘤25例,全部女性,平均年龄32.8岁.其中良性囊性畸胎瘤21例,恶性未成熟畸胎瘤4例.全部病例作了CT扫描.结果右侧12例,左侧13例,平均最大直径81mm.20例圆或椭圆形,5例不规则形.24例见脂质成分存在.21例良性者16例显示壁结节,3例为实质性肿块,2例见脂/液平面;4例恶性者密度不均匀.20/25例见钙化或骨化.2例恶性者并有腹膜转移.结论发生于卵巢的含有脂质成分和钙化或骨化斑者应考虑本病诊断.     

Collision tumors of the ovary associated with teratoma: clues to the correct preoperative diagnosis

PURPOSE: Collision tumors represent a coexistence of two adjacent but histologically distinct tumors without histologic admixture in an organ. The purpose of this study was to describe the imaging findings of collision tumors of the ovary associated with teratoma and to look for clues that might lead to the correct preoperative diagnosis. METHOD: Seven pathologically proven cases of collision tumor of the ovary associated with teratoma were retrospectively reviewed. Ovarian teratomas were coexistent with mucinous cystadenoma (n = 4), borderline mucinous tumor (n = 1), mucinous cystadenocarcinoma (n = 1), and dysgerminoma (n = 1). US (n = 5), CT (n = 3), and/or MRI (n = 4) findings were evaluated. RESULTS: In addition to the typical findings of teratoma, the mass contained a multiloculated cystic portion filled with nonfatty fluid, suggesting the coexistent epithelial tumor in five cases. In one case, the mass contained a large solid component, suggesting the possibility of collision tumor. In the remaining one case, coexistent small mucinous cystadenoma could not be identified. CONCLUSION: Preoperative imaging for ovarian teratoma revealed a collision tumor in six of seven cases. The possibility of a collision tumor should be considered when an ovarian teratoma has imaging findings that cannot be explained solely by an ovarian teratoma.     

囊性胸腺瘤和囊性畸胎瘤的影像学特征及鉴别诊断

目的 探讨囊性胸腺瘤和囊性畸胎瘤的影像学特征, 以提高两者的诊断正确率。 方法 回顾性分析经手术后病理证实的18例囊性胸腺瘤和12例囊性畸胎瘤患者的X线及CT影像学表现, 所有患者均行X线检查和CT平扫+增强扫描。 结果 肿瘤主要局限在前上纵隔或部分延伸至前中纵隔, 而且大多数肿瘤多偏向一侧。囊性胸腺瘤有明显分叶, 肿瘤几乎囊变, 部分可见小壁结节, 邻近血管结构多受推移, 部分病灶可压迫肺组织; 部分肿瘤可继发胸部改变如胸腔积液等。畸胎瘤基本上都含有囊变, 但肿瘤内未见明显骨性及脂性成分, 肿瘤内密度不均匀, 肿瘤并不是完全囊变。 结论 囊性胸腺瘤与囊性畸胎瘤各自具有一定的病理学及影像学特征, 根据其影像特征并结合其临床表现, 能对两者进行鉴别诊断。     

Rare case of an adult teratoma of the stomach (author's transl)]

The teratoma is a dysgenetic tumor consisting of tridermal differentiation products. The most common classification is made according to maturity - benign adult teratoma and malign nonmature embryonal teratoma. In the case demonstrated, a 15-year-old male suffers from tiredness, paleness and pains in the epigastrium. The radiological examination showed a tumor in the size of a fist with a number of teeth located partly within the stomach. The histological findings after operation confirmed the diagnosis of a coetaneous (= adult) gastric teratoma. The discussion shows that all cases of gastric teratoma published until 1972 are male, in 77% under the age of 1 year, in 13% under the age of 10, and only in 10% over the age of 10 years.     

卵巢囊性成熟性畸胎瘤的X线诊断和临床意义(附131例分析)

目的 :探讨 X线检查对卵巢囊性成熟性畸胎瘤的诊断价值和临床指导意义。方法 :131例行常规 X线检查发现囊性成熟性畸胎瘤 ,所有病例均经手术病理证实。结果 :X线报告符合率为 97.3% ,优于 B超。 145个卵巢囊性成熟性畸胎瘤中 ,47个仅表现为低密度阴影 ,36个仅表现为特异性的骨片、牙齿等致密影 ,6 2个既有低密度影 ,又有致密影。结论 :常规 X线检查在诊断卵巢囊性成熟性畸胎瘤方面占一些优势。     

Gliomatosis peritonei: MRI appearances and its potential role in follow up

Gliomatosis peritonei is a rare complication of ovarian teratomas characterized by peritoneal implants of glial tissue. Glial tissue in such cases is usually low grade although there have been cases of malignant evolution described. There is no clear guidance as to how often and for how long these patients should be followed up. There are clear dose implications when performing multiple CT scans. We present a case of immature ovarian teratoma complicated by the development of low grade gliomatosis peritonei. The MRI appearances are presented and described, and we discuss the potential role of MRI in the follow up of such cases.     

Extraosseous localization of technetium-99m MDP in benign cystic teratoma

Two cases of primary retroperitoneal benign teratoma, in which Tc-99m MDP localized in the primary tumor are presented. Localization of bone-imaging agents in neuroblastoma has been reported but, extraosseous localization of bone-imaging agents in teratomas has not been confirmed.     

Imaging of Ovarian Teratomas in Children: A 9-Year Review

Objective

Germ cell tumours are the most common ovarian neoplasms in childhood and, of these, teratomas, whether mature or immature, are the most frequently found. Mature teratoma is a benign tumour, whereas the immature type, although also benign, has a more aggressive course, with a propensity to recurrence. A review of the literature revealed that there are some imaging features that may help to differentiate between these 2 types of teratoma, although no systematic comparison has been made. The objective of this study was to review imaging features of ovarian teratomas in children and to assess differentiating imaging features between the mature and immature types of ovarian teratoma.

Methods

Retrospective analysis of all patients who presented to our institution during a 9-year period (September 1999 to August 2008) with ovarian teratoma as confirmed on histology.

Results

Forty-one patients with pathologically proven ovarian teratoma were found. The patient ages ranged from 4–18 years at presentation (mean [standard deviation] age, 12.4 ± 3.4 years; median age, 13 years). Thirty patients (73.2%) were found to have mature ovarian teratoma, and 11 (26.8%) had immature teratoma. A component of endodermal sinus tumour was found in one of the immature teratomas. On ultrasonography, the appearance of the immature teratomas was purely solid in 3 (27.3%), mixed solid and cystic in 6 (54.5%), and predominantly cystic in 2 (18%). The mature ovarian teratomas demonstrated a predominantly cystic appearance in 22 (73.3%) and a mixed solid and cystic appearance in 8 (26.6%); there were no cases with a pure solid appearance. The prevalence of the more cystic appearance of the mature type showed significant statistical difference when compared with its prevalence in the immature type (P = .0008, χ² test). Other imaging features, such as size, presence of fat, or calcifications, did not show a significant difference between the 2 types of teratoma.

Conclusions

The predominance of a cystic component and a pure solid component in ovarian teratoma are significant differentiating factors between the mature type and the more aggressive immature type of teratoma.     

颅内畸胎瘤的CT、MRI诊断

目的　探讨颅内畸胎瘤的CT、MRI表现 ,以提高对本病的认识。资料与方法　分析 4例经手术病理证实的颅内畸胎瘤资料 ,4例术前均行MRI扫描 ,3例并行CT扫描。结果　 1例单纯原发畸胎瘤 ,2例畸胎瘤破裂 ,1例畸胎瘤混合胶质瘤。畸胎瘤在影像学上具有特征性表现 ,CT可以清楚显示畸胎瘤内钙化灶及脂肪密度。MRI对脂肪信号特别敏感 ,尤其脂肪抑制序列可以鉴别脂肪和出血。结论　颅内畸胎瘤存在形式是多种多样的 ,可表现为单纯原发畸胎瘤 ,畸胎瘤也可以破裂 ,亦可合并其他肿瘤 ,具有特征性影像学表现。CT、MRI对颅内畸胎瘤术前可以作出定位及定性诊断     

肾上腺畸胎瘤的影像诊断

目的　探讨肾上腺畸胎瘤影像表现 ,提高对本病的认识。方法　报告 4例经手术病理证实的肾上腺畸胎瘤的影像所见 ,IVP检查 2例 ,B超 3例、CT检查 4例 ,MRI和肾动脉造影各 1例。结果　 4例均位于右侧肾上腺 ,IVP示肾上腺区钙化灶 ,CT表现为右肾上腺显示不清。肿瘤分别表现为以水样密度、脂肪密度或实性密度为主的混合密度块 ,增强扫描肿瘤实质部分、包膜及分隔有强化 ,MRIT1、T2 WI均显示肿瘤为不均质性高信号。B超显示肾上腺区不均质强光团和多种成分回声。结论　CT、MRI对肾上腺畸胎瘤诊断和鉴别诊断优于IVP和B超。     

肾上腺畸胎瘤的CT表现

目的探讨肾上腺畸胎瘤的CT表现。方法收集分析经手术病理证实的4例肾上腺畸胎瘤的CT资料。结果所有病例均为右侧发病，最大直径5．5cm-11．6cm，肿瘤分别表现为以水样密度、脂肪密度或实性密度为主的混合密度块，增强扫描肿瘤实质部分、包膜及分隔有强化，病灶内脂肪及水样密度成分无强化。结论肾上腺畸胎瘤虽然罕见，但其CT表现具有一定特征性，应准确定位并耐心分析其CT表现，避免误诊。     

卵巢畸胎瘤的CT表现

目的:研究卵巢畸胎瘤的CT表现,提高CT诊断的准确性。方法:搜集手术病理证实的卵巢畸胎瘤18例共计20个肿瘤,对其CT表现作回顾性分析。结果:18例卵巢畸胎瘤,平均34.2岁,其中良性囊性畸胎瘤18个,恶性未成熟畸胎瘤2个。右侧9个,左侧11个,平均最大直径87mm。17个呈圆形或椭圆形,3个为不规则形。18个见脂质成分存在。18个良性者14个显示壁结节,2个见脂-液平面;2个恶性者密度不均匀。13个见钙化或骨化。本组20个肿瘤平扫CT的敏感度100%,特异度95%,诊断符合率为95%。结论:发生于卵巢的含有脂质成分和钙化或骨化斑者应考虑本病。     

原发性颅内畸胎瘤的MRI诊断

目的　探讨MRI对畸胎瘤的诊断价值。方法　 9例经手术和病理证实的畸胎瘤患者 ,对其MR表现进行分析。结果　本组术前MRI诊断定位正确率为 10 0 % ,定性正确率 (8/9)为 88.8%。其MRI特征性表现为 :(1)肿瘤形态以分叶状为主 ,边界清楚。(2 )肿瘤信号多不均匀 ,表现复杂。 (3 )Gd -DTPA增强肿瘤呈不均匀强化。结论　MRI的多轴位成像及Gd -DTPA应用有助于畸胎瘤的诊断与鉴别诊断