纵隔内胚窦瘤的MSCT表现及诊断价值

目的探讨纵隔内胚窦瘤(mediastinal endodermal sinus tumor,MEST)的多层螺旋CT(MSCT)表现,提高临床诊断水平。方法回顾性分析7例病理证实的纵隔内胚窦瘤的MSCT表现。结果 7例病例均位于前纵隔,其中前上纵隔4例,前中上纵隔3例;CT平扫显示肿块均为实性软组织肿块,边界不清;6例密度不均匀,5例肿块内部可见坏死囊变,2例可见不规则钙化;增强扫描肿块中度～高度不均匀强化;1例较大肿块内可见强化血管。结论纵隔内胚窦瘤CT表现具有一定的特征性,MSCT图像后处理有利于病变细微结构的显示,根据CT表现可以提示诊断并帮助确定手术方案和推测预后,但确诊需依靠病理学。

MSCT manifestations and diagonostic value of mediastinal endodermal sinus tumor

Objective To explore MSCT manifestations of mediastinal endodermal sinus tumor(MEST).Methods MSCT features of 7 cases with MEST were analyzed retrospectively.Results The tumors of the total 7 cases located in anterior mediastinum,including upper mediastinum(n=4),anterior middle upper mediastinum(n=3),respectively.At unenhanced CT,the tumor of each case presented with bad-defined margins and soft tissue tumor.Of the 7 cases,6 cases presented with relatively hetergeneous attenuationin,5 cases with necrosis,and 2 cases with calcification.At contrast enhanced CT,tumor showed mid-height range inhomogencous enhancement,and vessels were seen in 1 large MEST.Conclusion MEST is a rare tumor with the specifity of the MSCT manifestations;the MSCT image-postprocessing is very helpful for MEST demonstration;CT features can not only indicate the diagnosis of the diseases and help surgical planning but also estimate the prognosis.Final diagnosis depends on pathology.