基底节区生殖细胞瘤的临床及影像学特点分析
| 作者: |
1李海龙,
1张剑宁,
2米良,
1郑春玲,
1孙艳杰,
1刘锐,
1于新,
1王亚明
1 中国人民解放军海军总医院神经外科，北京 100048 2 延安大学附属医院神经外科，陕西 延安 716000 |
| 通讯: |
李海龙
Email: neurosurgeonli@163.com 王亚明 Email: hzwyming@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2015.05.014 |
摘要
目的：介绍基底节区生殖细胞瘤的临床和影像学特点。方法：回顾性分析我科活检病理证实的35 例基底节区生殖细胞瘤的临床资料和影像学特点，并行统计学分析常见影像特征与临床特点的关系。结果：男性30例，女性5例，症状为缓慢进行性肢体偏瘫12例。平均年龄(18.3±1.5)岁，病程平均(8±1.6)个月。影像学上5例呈多发病灶，30例单发，出血2例，钙化2例，囊变16例，同侧大脑皮质及大脑脚萎缩16例，不均匀轻度或中度增强，瘤周水肿较轻，占位效应不明显，平均肿瘤最大径3.2±0.2 cm。所有患者均行立体定向活检手术明确病理诊断，无手术并发症。仅肿瘤最大径与是否伴有皮质或脑干萎缩有近似统计学差异(P=0.075)。结论：基底节区生殖细胞瘤临床上以青年男性多见，肢体偏瘫为常见症状，影像学上囊变多见，占位效应及瘤周水肿不明显，如同时伴有同侧大脑皮质及大脑脚萎缩则应高度怀疑，此时应通过穿刺活检明确病理或试验性放疗排除。
关键词：
基底节
生殖细胞瘤
脑干萎缩
华勒变性
计算机断层扫描
磁共振
Clinical and radiological features of thirty-five cases with basal ganglia germinoma
CorrespondingAuthor: LI Hai Long Email: neurosurgeonli@163.com
DOI: 10.3978/j.issn.2095-6959.2015.05.014
Abstract
Objective: To investigate the clinical and radiological characteristics of basal ganglia germinoma (BGG). Methods: Thirty five patients with pathologically confirmed BGG were enrolled retrospectively. Results: There were 30 males and 5 females, with mean age of 18 years. Hemiparalysis and high intracranial pressure were major symptoms. Imaging showed that cytolization, ipsilateral cerebral or brain stem atrophy, slight mass effect were frequent in BGGs. Chi-square test was used to analyze where ipsilateral cerebral or brain stem atrophy correlated with sex, hemiparalysis, cytolization and tumor size. There were no surgical complications. Only tumoe size showed marginally statistical significance with ipsilateral cerebral or brain stem atrophy (P=0.075). Conclusion: BGG characterized young male, hemiparalysis, cytolization, slight mass effect and ipsilateral cerebral or brain stem atrophy.