Buetow P C, Smirniotopoulos J G, Done S
Department of Radiology, Walter Reed Army Medical Center, Washington, DC 20307-5001.
AJNR Am J Neuroradiol. 1990 Jul-Aug;11(4):793-9.
Forty-five pathologically proved cases of neonatal brain tumors (diagnosed in neonates within 60 days after birth) were reviewed from the neuroradiology archives dating back to 1964. CT was performed in 24 cases, MR in five, sonography in six, and angiography in seven. Two-thirds of the lesions were supratentorial. The most common histology was a tumor composed of primitive or poorly differentiated tissues: 12 teratomas and 12 primitive neuroectodermal tumors, four of which were typical medulloblastomas. In addition, there were nine astrocytomas (grades I-III); four cases of glioblastoma multiforme (astrocytoma grade IV); three choroid plexus papillomas; and single cases each of ependymoma, medulloepithelioma, germinoma, angioblastic meningioma, and ganglioglioma. The dominant CT appearance, regardless of histology, was a large heterogeneous lesion with associated hydrocephalus. Coarse calcification was a constant feature in the teratomas. Prognosis was poor overall, with the longest survival seen in choroid plexus papilloma and astrocytoma. Imaging studies are most valuable in identifying and distinguishing potentially curable lesions such as choroid plexus papillomas (variably sized intraventricular lesions with homogeneous enhancement) from rapidly fatal tumors such as teratomas (large heterogeneous lesions with coarse calcifications and associated hydrocephalus).
回顾了自1964年以来神经放射学档案中45例经病理证实的新生儿脑肿瘤病例（出生后60天内诊断为新生儿）。其中24例行CT检查，5例行MR检查，6例行超声检查，7例行血管造影检查。三分之二的病变位于幕上。最常见的组织学类型是由原始或低分化组织构成的肿瘤：12例畸胎瘤和12例原始神经外胚层肿瘤，其中4例为典型的髓母细胞瘤。此外，有9例星形细胞瘤（Ⅰ-Ⅲ级）；4例多形性胶质母细胞瘤（星形细胞瘤Ⅳ级）；3例脉络丛乳头状瘤；以及各1例室管膜瘤、髓上皮瘤、生殖细胞瘤、血管母细胞性脑膜瘤和节细胞胶质瘤。无论组织学类型如何，CT的主要表现为大的不均匀病变并伴有脑积水。粗大钙化是畸胎瘤的一个恒定特征。总体预后较差，脉络丛乳头状瘤和星形细胞瘤的生存期最长。影像学研究在识别和区分潜在可治愈的病变（如脉络丛乳头状瘤，表现为大小不一的脑室内病变且强化均匀）与快速致命的肿瘤（如畸胎瘤，表现为大的不均匀病变、粗大钙化并伴有脑积水）方面最有价值。
