Imaging characteristics of primary intracranial teratoma
Imaging characteristics of primary intracranial teratoma
复制标题
原发性颅内畸胎瘤的影像学特征
DOI：
10.1177/0284185113507824
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发表时间：
2014-09-01
期刊：
影响因子：
1.3
通讯作者：
Qiu, Shijun
中科院分区：
文献类型：
--
作者：
Liu, Zhenyin;Lv, Xiaofei;Qiu, Shijun
原发性颅内畸胎瘤是一种罕见的颅内肿瘤，可分为成熟畸胎瘤、未成熟畸胎瘤和恶性畸胎瘤。迄今为止，只有少数研究畸胎瘤成像已报告。目的描述18例经病理证实的畸胎瘤患者（16例男性/男孩，2例女性/女孩;平均年龄14.5岁）的磁共振成像（MRI）表现。材料与方法回顾性分析2001年至2011年我院收治的18例经手术病理证实的颅内畸胎瘤患者的临床资料和影像学表现。两名放射科医生评估病变的位置、形状、大小、数量、边缘、均匀或不均匀的外观、衰减、信号强度和增强程度。结果肿瘤位于松果体区13例，鞍旁2例，鞍上3例。MRI显示病变为混合信号，反映了组织学异质性，包括纤维化、脂肪组织、钙化、囊肿和角质形成细胞。在成熟畸胎瘤（n = 9）中，9个肿瘤中有7个在对比增强T1加权（T1 W）图像上显示囊壁无增强的多房性或不均匀增强。9个肿瘤中有2个在病灶的实性部分显示中度不均匀增强;而在未成熟畸胎瘤（n = 7）或恶性转化畸胎瘤（n = 2）中，在T1 W图像上观察到不均匀的环状斑片状增强。结论原发性颅内畸胎瘤好发于松果体及鞍上区，MRI表现为卵圆形或分叶状肿块，可有或无多房性。肿瘤实性部分或厚壁明显强化是鉴别成熟畸胎瘤与恶性畸胎瘤的关键。
Background Primary intracranial teratomas are rare intracranial neoplasms, and are subdivided into mature, immature, and those with malignant transformation. To date, only a few studies of teratoma imaging have been reported. Purpose To describe and characterize the magnetic resonance imaging (MRI) findings in a series of 18 patients (16 men/boys and 2 women/girls; mean age, 14.5 years) with pathologically proven teratomas. Material and Methods Findings from medical records and imaging examinations in 18 patients with pathologically confirmed intracranial teratomas from 2001 to 2011were retrospectively reviewed at our two institutions. Two radiologists evaluated the lesion location, shape, size, number, edge, homogeneous or heterogeneous appearance, attenuation, signal intensity, and degree of enhancement. Results All tumors were located within the pineal (n = 13), parasellar (n = 2), or suprasellar (n = 3) regions. The lesions appeared of mixed intensity on MRI, reflecting the histologic heterogeneity, including fibrosis, fatty tissue, calcification, cysts, and keratinocytes. In mature teratomas (n = 9), seven of nine tumors showed non-enhanced multilocularity or heterogeneous enhancement of the cyst wall on contrast-enhanced T1-weighted (T1W) images. Two of nine tumors showed moderate, heterogeneous enhancement in the solid portion of the lesion; whereas in immature (n = 7) or malignant transformation (n = 2) teratomas, heterogeneous, ring-like, intratumoral patchy enhancement was noted on T1W images with contrast. Conclusion Primary intracranial teratomas are usually localized in the pineal and the suprasellar regions, and often present an ovoid or lobulated mass with or without multilocularity on MRI. Marked enhancement of the solid portion or the thick wall of the tumor was the key feature for distinguishing mature teratoma and malignant teratoma.