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目的分析颅内绒毛膜上皮癌的影像学表现,提高其诊断符合率。资料与方法回顾性分析4例经病理证实的颅内绒毛膜上皮癌,4例均行MRI头颅平扫和增强扫描,使用Siemens Vision Plus 1.5 T或GE 3.0 SignaExite超导型磁共振扫描仪;2例行CT头颅平扫,1例行CT头颅平扫和增强扫描,采用Somatom Plus 4全身CT扫描机或GE Light Speed 16螺旋CT扫描仪。结果 4例人绒毛膜促性腺激素(HCG)均明显增高。3例颅内原发性绒毛膜上皮癌,均位于松果体区且均为男性;1例颅内继发性绒毛膜上皮癌,发生在脑实质内,为女性。CT扫描呈团块状或分叶状混杂密度影,内可见小点状或斑块状高密度钙化灶;增强扫描肿块呈轻中度强化。MRI呈不均匀混杂T1、T2信号,可见低信号含铁血黄素沉着及钙化,幕上脑室不同程度积水,增强扫描实性部分呈较明显不均匀强化。结论颅内绒毛膜上皮癌易发生肿瘤内出血或肿瘤卒中,结合临床特点及实验室检查可在术前作出较为准确的诊断,但最终确诊仍依靠病理及免疫组织化学。
Objective To analyze the imaging findings of intracranial choriocarcinoma and to improve the diagnostic coincidence rate. Materials and Methods Retrospective analysis of 4 cases of pathologically confirmed intracranial choriocarcinoma, 4 patients underwent MRI cranial scan and enhanced scan using Siemens Vision Plus 1.5 T or GE 3.0 SignaExite SCF; 2 Routine CT skull imaging, CT skull imaging and contrast enhancement were performed in one patient. A Somatom Plus 4 CT scanner or GE Light Speed 16 CT scanner was used. Results 4 cases of human chorionic gonadotropin (HCG) were significantly higher. 3 cases of intracranial primary choriocarcinoma, located in the pineal region and are male; 1 case of intracranial secondary choriocarcinoma, occurred in the brain parenchyma, female. CT scans were lumpy or lobulated mixed density shadow, dot-like or plaque-like high-density calcification within the enhanced scan mass was mild to moderate enhancement. MRI uneven heterogeneous mixed T1 and T2 signals, showing low signal hemosiderin and calcification, supratentorial ventricle of varying degrees of water, enhance the solidified part of the scan was significantly more uneven enhancement. Conclusion Intracranial choriocarcinoma is prone to have intracranial hemorrhage or tumor strokes. Combined with clinical features and laboratory tests, it is possible to make a more accurate diagnosis before surgery, but the final diagnosis is still based on pathology and immunohistochemistry.