Kanoto M, Toyoguchi Y, Hosoya T, Kuchiki M, Sugai Y
Department of Diagnostic Radiology, Yamagata University Faculty of Medicine, Iida-Nishi 2-2-2, 990-9585, Yamagata, Japan,
Clin Neuroradiol. 2015 Mar;25(1):55-60. doi: 10.1007/s00062-013-0282-2. Epub 2014 Jan 30.
Atypical teratoid/rhabdoid tumor (AT/RT) occurs in children less than 3 years old, and has a very poor prognosis. AT/RT seldom occurs in adult. We have experienced four cases of AT/RT at our institute. The purpose of this study is to evaluate the radiological image findings of adult-onset AT/RT and to conduct a systematic review.
Image findings of four AT/RTs in our institute were retrospectively evaluated by an experienced neuroradiologist. If the images were unavailable, image findings were evaluated from the former image interpretation report. We assembled papers of adult-onset AT/RT (n = 38) and evaluated the image findings.
AT/RT occurs in a variety of sites (spinal region, pineal region, suprasellar region, jugular foramen, and so on). High density on computed tomography (CT) was seen in 10 of 11 cases; mixed intensity in T2-weighted image was seen in 13 of 18 cases; and high intensity on diffusion-weighted image (DWI) was seen in 3 of 3 cases. Contrast enhancement was observed in all cases in which images were available.
We have experienced four adult-onset AT/RT cases at our institute and have evaluated image findings through systematic review. The image findings of high density on CT, high intensity on DWI, with low apparent diffusion coefficient, and a heterogenous component should lead to an inclusion of AT/RT in the differential diagnosis of a tumor; these findings may be able to suggest AT/RT; however, they cannot make the diagnosis.
非典型畸胎样/横纹肌样瘤(AT/RT)发生于3岁以下儿童,预后极差。AT/RT在成人中很少见。我们机构诊治过4例AT/RT。本研究的目的是评估成人发病的AT/RT的影像学表现并进行系统综述。
由一位经验丰富的神经放射科医生对我们机构4例AT/RT的影像表现进行回顾性评估。如果图像不可用,则根据之前的影像解读报告评估影像表现。我们收集了成人发病的AT/RT的文献(n = 38)并评估其影像表现。
AT/RT发生于多个部位(脊髓区、松果体区、鞍上区、颈静脉孔等)。11例中有10例在计算机断层扫描(CT)上表现为高密度;18例中有13例在T2加权图像上表现为混合密度;3例中有3例在扩散加权图像(DWI)上表现为高信号。在所有可获得图像的病例中均观察到对比增强。
我们机构诊治过4例成人发病的AT/RT病例,并通过系统综述评估了影像表现。CT上的高密度、DWI上的高信号、低表观扩散系数以及异质性成分的影像表现应将AT/RT纳入肿瘤的鉴别诊断;这些表现可能提示AT/RT,但不能确诊。