鞍区生殖细胞瘤临床与CT关系分析

本文对16例鞍区生殖细胞瘤的临床和CT资料进行了分析。结果表明,本病好发于儿童及青年,女性多见。临床常表现为尿崩症、视力障碍及丘脑下部-垂体功能紊乱。CT检查可确定肿瘤的部位,反映肿瘤的内部结构,提供恶性肿瘤的诊断依据以及确定脑积水的梗阻部位、发现蝶鞍局限性骨质破坏等。鞍区生殖细胞瘤起源于丘脑下部,如漏斗、视交叉、垂体柄等。肿瘤平扫呈高密度,少数可有多发、散在、小的低密度区;增强CT强化显著,低密度区无强化。肿瘤形态不规则,边界不清楚,沿脑脊液循环种植性转移及沿邻近室管膜浸润生长等,可视为恶性肿瘤征象,后者对本病具有特征性意义。另外,部分病例鞍区与松果体医生殖细胞瘤并存,检查中要注意寻找。

CLINICAL AND CT DATA OF SELLAR REGION GERMINOMAS

The clinical and CT data of 16 cases of germinonas in the sellar region were ana-lyzed. The results show that the tumor usually occurs in children and young people andmostly in females. Diabetes insipidus, visual disturbance and hypothalamic-pituitarydysfunction are most common clinical manfestations. By CT scanning, the tumor posi-tions can be affirmed, and the inner structures, the malignant signs, the site of obstruc-tion and hydrocephalus and local lone destruction in the sella turcica can be shown. Thesuprasellar tumon is usually located in the hypothalamus and sometimes, in the opticchiasm and lever. The intrasellar tumor may be located in the hypophyseal stalk. Thetumor presents high density with no calcification in plain CT, and sometimes has smallbut multiple and scattered low density areas. In enhanced CT, it shows obvious enhance enhance ment, but the low density areas do not show enhancement. Irregular-shapes,unclear margins, metastasis into the ventricles and subarachnoid space in the form ofimplantation and infiltration along nearby ventricular walls may all be malignant signs,the later most being characteristic. In addition, the diseaes is sometimes accompanied bypineal germinomas, which should be looked for carefully in CT diagnosis.