颅内生殖细胞瘤的MRI影像表现及诊断

目的 探讨颅内生殖细胞瘤的MRI表现，旨在提高对本病的影像诊断准确率。方法 回顾性分析2014年12月~2019年5月我院经手术病理或临床诊断性放射治疗确诊的13例颅内生殖细胞瘤患者的MRI影像资料，分析其临床表现、影像表现及诊断。结果 病变位于松果体区患者9例，MRI检查肿瘤实质部分T1WI呈稍低信号，T2WI和FLAIR 呈高或稍高信号，DWI呈等或稍高信号，增强扫描呈明显强化；肿瘤伴有囊变者1例，伴有钙化者3例，4例患者伴脑积水；3例患者出现转移灶，累及三脑室、侧脑室等，其MRI信号及强化方式与原发灶相似。病变位于鞍区患者3例，肿瘤形态、大小不一，T1WI 呈稍低信号，T2WI和FLAIR 呈稍高信号，增强扫描呈明显强化。1例患者的病变位于右侧基底节区，形态不规则，T1WI呈等信号，T2WI、FLAIR及DWI均呈稍高信号，增强扫描无强化，同侧大脑脚较对侧萎缩。结论 MRI对颅内生殖细胞瘤的影像诊断与鉴别诊断具有重要价值。

MRI Imaging Findings and Diagnosis of Intracranial Germ Cell Tumor

Objective To investigate the MRI findings of intracranial germ cell tumors in order to improve the accuracy of imaging diagnosis of this disease. Methods The MRI images of 13 patients with intracranial germ cell tumors diagnosed by surgical pathology or diagnostic radiotherapy in our hospital from December 2014 to May 2019 were retrospectively analyzed. The clinical manifestations, imaging findings and diagnosis were analyzed. Results There were 9 patients with lesions in the pineal region.MRI examination showed that the tumor parenchyma showed a slightly lower signal on T1WI, T2WI and FLAIR showed higher or slightly higher signal, DWI showed equal or slightly higher signal, enhanced scan showed obvious enhancement; tumor with cystic change in 1 case, accompanied by calcification in 3 cases 4 patients with hydrocephalus; 3 patients with metastases, involving the third ventricle, lateral ventricle, etc., MRI signal and enhancement methods similar to the primary lesion. There were 3 patients with lesions in the sellar region. The morphology and size of the tumors were different. T1WI showed a slightly lower signal, T2WI and FLAIR showed slightly higher signals, and enhanced scan showed obvious enhancement. The lesion of one patient was located in the right basal ganglia, and the shape was irregular. T1WI showed equal signals. T2WI, FLAIR and DWI showed slightly higher signals. The enhanced scan showed no enhancement, and the ipsilateral cerebral pedicle was atrophied.Conclusion MRI is of great value in the imaging diagnosis and differential diagnosis of intracranial germ cell tumor.