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目的研究基底节区生殖细胞瘤的CT、MRI及氢质子磁共振波谱(1H-MRS)表现,以提高对该病的诊断水平。资料与方法搜集6例经活检或手术病理证实的生殖细胞瘤,全部病例均行MRI平扫加增强扫描,其中4例加做CT平扫及增强扫描,3例行MRS检查,5例行追踪复查。对其影像学表现进行回顾分析。结果CT表现:2例点状钙化,2例囊实性肿块。MRI表现:3例为肿块状,3例为片状(复查时示肿块状)。T1WI上病灶呈低或等信号,T2WI呈高信号。增强后3例呈环状强化,2例轻度片状强化,1例显著均匀强化。3例呈片状肿瘤者行MRS检查,首诊时胆碱(choline,Cho)、氮-乙酰天门冬氨酸(N-acetyl aspartate,NAA)、肌酸(creatine,Cr)峰的形态大致正常,2例NAA/Cho和NAA/Cr下降,并见脂质(Lip)/乳酸(Lac)峰,1例复查时Cho峰升高,NAA、Cr峰降低。结论CT、MRI在基底节区生殖细胞瘤的诊断中具有一定的局限性,1H-MRS发现NAA/Cho、NAA/Cr比值下降和出现Lip/Lac峰,建议临床进行穿刺活检以早期诊断。
Objective To study the CT, MRI and 1H-MRS findings of basal ganglia germ cell tumors in order to improve the diagnosis of the disease. Materials and Methods Six cases of germ cell tumor confirmed by biopsy or surgical pathology were collected. All patients underwent MRI scan and contrast enhanced scan. Among them, 4 patients underwent CT scan and enhanced scan, 3 underwent MRS and 5 underwent follow-up Review. The imaging findings were analyzed retrospectively. Results CT manifestations: 2 cases of punctate calcification, 2 cases of cystic mass. MRI manifestations: 3 cases were lumps, 3 cases were flaky (re-examination showed lumps). T1WI lesion showed low or equal signal, T2WI showed high signal. After the enhancement, 3 cases showed ring enhancement, 2 cases mild platelet enhancement, and 1 case was significantly uniform enhancement. MRS was performed in 3 cases with flaky tumors. The shape of choline (Cho), N-acetyl aspartate (NAA) and creatine (Cr) peaks were almost normal , 2 cases of NAA / Cho and NAA / Cr decreased, and see Lip (Lip) / lactate (Lac) peak, 1 case of Cho peak increased, NAA, Cr peak decreased. Conclusions CT and MRI have some limitations in the diagnosis of basal ganglia germ cell tumor. 1H-MRS found that NAA / Cho, NAA / Cr ratio decreased and Lip / Lac peak appeared. It is suggested that biopsy should be performed clinically in early diagnosis.