Fujimaki T, Matsutani M, Funada N, Kirino T, Takakura K, Nakamura O, Tamura A, Sano K
Department of Neurosurgery, University of Tokyo Hospital, Japan.
J Neurooncol. 1994;19(3):217-26. doi: 10.1007/BF01053275.
The computed tomographic (CT) and magnetic resonance imaging (MRI) features of 73 histologically proven primary intracranial germ cell tumors were analysed. CT images were available for all 73 patients, and 22 of them were also examined by MRI. The tumors were classified as germinoma, mature teratoma, immature or malignant teratoma, yolk sac tumor, choriocarcinoma, embryonal carcinoma and mixed type. Germinoma was revealed as a high- or slightly high-density area on plain CT scan, and was enhanced homogeneously. MRI revealed iso- or slightly low signal intensity on T1-weighted images, and iso- or high intensity on T2-weighted images. Mature teratoma, which had a clear margin on neuroradiological images, was characterized by mixed density on CT scans, often showing large cysts and area of calcification. Immature or malignant teratoma had a similar pattern to that of mature teratoma, but the cystic components and area of calcification tended to be less and smaller respectively. The tumor margin was obscure in malignant teratoma, and perifocal edema was observed in some cases. The shape of yolk sac tumors was irregular. Plain CT scan revealed an iso- or low-density mass with good heterogeneous enhancement. Perifocal edema was observed in some cases. In mixed germ cell tumors, MRI imaging was useful for detecting teratomatous components, particularly fatty components. Although definite histological diagnosis cannot be achieved by CT and/or MRI alone, detailed analysis of neuroradiological images are useful for predicting the histological diagnosis.
分析了73例经组织学证实的原发性颅内生殖细胞肿瘤的计算机断层扫描（CT）和磁共振成像（MRI）特征。所有73例患者均有CT图像，其中22例还接受了MRI检查。肿瘤分为生殖细胞瘤、成熟畸胎瘤、未成熟或恶性畸胎瘤、卵黄囊瘤、绒毛膜癌、胚胎癌和混合型。生殖细胞瘤在CT平扫上表现为高密度或略高密度区，增强均匀。MRI在T1加权图像上显示等信号或略低信号强度，在T2加权图像上显示等信号或高信号强度。成熟畸胎瘤在神经放射学图像上边界清晰，CT扫描表现为混合密度，常可见大囊肿和钙化区。未成熟或恶性畸胎瘤与成熟畸胎瘤表现相似，但囊性成分和钙化区往往分别较少和较小。恶性畸胎瘤边界不清，部分病例可见灶周水肿。卵黄囊瘤形态不规则。CT平扫显示等密度或低密度肿块，不均匀强化明显。部分病例可见灶周水肿。在混合性生殖细胞肿瘤中，MRI成像有助于检测畸胎瘤成分，尤其是脂肪成分。虽然仅通过CT和/或MRI不能明确组织学诊断，但神经放射学图像的详细分析有助于预测组织学诊断。
