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     

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.     

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     

Intracranial choriocarcinoma

A case of intracranial choriocarcinoma (probably primary), a rare variety of atypical teratoma, is reported. Diagnosis and treatment were based on radiological and hormonal studies. The usefulness of computed tomography (CT) in the follow-up and treatment of patients with tumors in areas not easily accessible for surgical exploration or biopsy is again documented. The CT findings correlated well with the documented hormonal changes as well as with the patient's clinical status.     

胎儿颅内实质性肿瘤的产前超声诊断

目的 探讨产前超声诊断胎儿颅内实质性肿瘤的价值.资料与方法 回顾性分析13例经病理确诊的颅内实质性肿瘤胎儿的超声声像图特征,并追踪随访结果.结果 13例胎儿超声诊断结果中,11例与解剖病理结果相符,诊断符合率为84.6％,其中畸胎瘤4例、胶质细胞瘤1例、脉络丛乳头状瘤2例、结节性硬化症2例、脂肪瘤2例.1例神经节星形胶...     

颅内生殖细胞肿瘤的MRI诊断与鉴别诊断

目的分析总结颅内生殖细胞肿瘤的MRI特征,提高其诊断准确性。方法回顾性分析经手术病理证实的颅内生殖细胞肿瘤15例,所有病例均行常规SE序列平扫及增强扫描,必要时加扫脂肪抑制序列。结果6例位于松果体区,6例位于鞍区(松果体区及鞍区生殖细胞瘤、畸胎瘤及绒毛癌均分别为3例、2例及1例),2例位于基底节区(均为生殖细胞瘤),1例位于右侧脑室(畸胎瘤)。结论MRI对颅内生殖细胞肿瘤的诊断与鉴别诊断具有重要价值。     

Fetal intracranial teratoma: US diagnosis of three cases and a review of the literature

We describe three cases of fetal intracranial teratoma diagnosed by ultrasound and review the literature. Sonographic features include cranial enlargement, gross distortion of normal cerebral architecture by a hyperechoic, multicystic mass, and polyhydramnios. Despite early diagnosis, the cesarean section rate is high and the overall prognosis is dismal.     

Floating ball appearance in ovarian cystic teratoma

The presence of floating fat balls or globules in an ovarian cystic teratoma is an unusual finding. Herein, we present ultrasonographic and tomographic findings of a rarely reported case of cystic teratoma with a floating fat ball.     

Teratoma of the parotid region: an uncommon disease. Apropos of a case with review of the literature

Cervicofacial teratoma is an infrequently reported tumor that is usually diagnosed at birth and is very rarely seen after one year of age. In the case reported, an exceptional finding was a teratoma of the parotid region in an adolescent. A literature review underlines the rarity of the lesion, diagnosis being assisted by radiologic and CT scan imaging.     

Computed tomography of benign cystic teratoma of the omentum

Benign cystic teratoma of the omentum is a rare gynecologic condition. No cases have been diagnosed preoperatively; six cases have been reported in association with an ovarian teratoma. We report a seventh case in which ultrasound and CT were used preoperatively.     

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.     

A giant partial thrombosed aneurysm of the internal cavernous carotid artery mimicking a meningioma of the lesser wing of the sphenoid bone

Giant intracranial aneurysms are defined as those with diameters of 25 mm or more and represent about 5% of all intracranial aneurysms. These aneurysms typically manifest during the fifth to seventh decades of life. Due to their size, giant aneurysms are responsible for intracranial mass effect rather than hemorrhage. Clinical symptoms depend on aneurysm''s location. Radiological features are not common for aneurysms of the internal cavernous carotid artery. Differential diagnosis includes pituitary adenoma, meningioma, craniopharyngioma, hamartoma, glioma, teratoma, and even granuloma.Here, the authors report a case of a 63-year-old female patient with a giant partial thrombosed aneurysm of the internal cavernous carotid artery mimicking a meningioma of the lesser wing of the sphenoid bone who presented for visual defect, and raised intracranial pressure. The authors will proceed with a literature review investigating this entity as well its ability of mimicking meningioma.     

Fetal brain tumors: Prenatal diagnosis by ultrasound and magnetic resonance imaging

Congenital central nervous system tumors diagnosed during pregnancy are rare, and often have a poor prognosis. The most frequent type is the teratoma. Use of ultrasound and magnetic resonance image allows the suspicion of brain tumors during pregnancy. However, the definitive diagnosis is only confirmed after birth by histology. The purpose of this mini-review article is to describe the general clinical aspects of intracranial tumors and describe the main fetal brain tumors.     

Fetal intracranial tumors: a review of 27 cases

Fetal intracranial tumors are rare. The diagnosis is generally made on histology after birth. The aim of this study was to analyze clinical and imaging data in a series of fetal intracranial tumors and emphasize the findings that may help approach the diagnosis antenatally. We retrospectively analyzed imaging and clinical findings in 27 cases of fetal intracranial tumors assessed by ultrasound (27/27) and MR imaging (24/27). A histological diagnosis was always obtained. Main diagnoses included 15 germinal tumors (13 teratomas), 4 glial tumors, 2 craniopharyngiomas and 3 hamartomas. Average gestational age at diagnosis was 27 weeks for teratomas, 21 weeks for hamartomas and 34 weeks for glial tumors. All tumors but one were supra tentorial, and the lesion extended in the posterior fossa in two teratomas. A heterogeneous pattern, which was more frequently seen in teratomas, was better visualized by MR than US imaging. In addition, in two cases of teratomas, MR imaging better assessed the extension of the tumor. Teratomas and gliomas are the most frequent brain tumors in the fetus. US and MR imagings appear complementary in the prenatal assessment of these lesions.     

光动力疗法治疗胶质瘤围手术期的护理

目的总结光动力疗Ok（Photodynamic therapy,PDT）治疗胶质瘤的临床护理经验。方法胶质瘤患者30例,其中颅内胶质瘤28例,恶性畸胎瘤2例。通过PDT治疗和术前准备、术中术后护理、出院指导使患者接受治疗,积极配合治疗和护理,促进病情恢复。结果30例患者中9例出现皮肤光敏反应,3例SGPT升高,肝肾功能轻微损害,其余均恢复良好。结论PDT治疗胶质瘤中认真、细致的观察与护理对治疗有重要作用。     

含短T_1信号的颅内先天性肿瘤的MRI表现及信号的病理基础

目的　探讨颅脑先天性肿瘤 MRI短 T1 高信号与肿瘤成分之间的关系 ,加深对该病的认识 ,提高影像诊断正确率。材料与方法　经手术病理证实的并在 MR T1 WI上表现为短 T1 高信号或混杂信号的 9例颅脑先天性肿瘤 ,全部行常规 MR检查及脂肪抑制序列扫描 ,将 MRI信号特征与病理结果进行对照分析。结果　颅咽管瘤 3例 ,在 T1 WI上均为混杂信号 ,其中 2例短 T1 高信号经 CT及病理证实为钙化 ,1例短 T1 高信号为脂肪成分。表皮样囊肿 4例 ,2例为均匀的短 T1 高信号 ,2例为混杂信号 ,肿瘤成分为液态的高浓度蛋白。皮样囊肿及畸胎瘤各 1例 ,均为混杂信号 ,其中的短 T1 高信号经脂肪抑制序列及术中所见证实为脂肪成分。结论　先天性肿瘤中的短 T1 高信号是由高浓度蛋白、脂肪及钙化成分组成。 MRI对先天性肿瘤有定性诊断价值     

Carcinoid tumor development in an intramedullary spinal cord mature teratoma.

The case of a 43-year-old woman with a several month history of severe back pain is reported. CT and MR imaging revealed an intramedullary cystic tumor, which was considered a dermoid cyst or teratoma. During surgery, the tumor was found within the base of the filum terminale and completely resected. Microscopic studies revealed a mature teratoma with an intramural carcinoid nodule. Thirteen-month follow-up after surgical resection showed no evidence of tumor recurrence or neoplasms elsewhere.     

The growing teratoma syndrome: radiologic findings in four cases.

Radiologic findings in four patients with metastatic mixed germ-cell tumors of the testis are presented. In all cases metastases had increased in size following chemotherapy in spite of normal biomarker levels, and histological study of the residual masses showed mature teratoma with an absence of malignant cells, thus confirming the diagnosis of growing teratoma syndrome. At present CT appears to be the best technique both for diagnosis and follow-up in these patients. In one case, the growing teratoma syndrome presented as cavitation of a pulmonary nodular lesion, a finding rarely described in the literature, and with CT demonstration not reported.     

Primary intracranial mixed choriocarcinoma and malignant teratoma.

Primary intracranila choriocarcinoma, either alone or with malignant teratoma, is a rare tumor. The 22 reported cases of primary intracranila mixed choriocarcinoma and malignant teratoma are reviewed, and a further case is added. This 4 1/2-year-old girl presented with multiple cranial nerve palsies, panhypopituitarism and markedly elevated blood and urine human chorionic gonadotrophin (HCG) titres. After subtotal removal of the suprasellar tumor, supervoltage radiation was given with a remarkably rapid and complete response. She died 14 months after diagnosis with no evidence of local recurrence nor of distant metastases.     

Malignant bilateral mediastinal teratoma: a case report]

The authors report a case of bilateral malignant teratoma of the mediastinum in a 40 year old female presenting with chest pain. Two separate bilateral soft tissue masses were noted in the mediastinum at imaging. On the right side, the mass was heterogeneous with large calcification and infiltration of the pericardium. On the left side, the mass was well defined, heterogeneous and without evidence of local invasion. The analysis of samples obtained by US guided puncture biopsy and surgical specimen of the two masses confirmed the diagnosis of pluricellular malignant teratoma. Mediastinal malignant teratomas represent 1 to 5% of all mediastinal tumors. To our knowledge, no case of synchronous bilateral mediastinal teratoma has never been reported.