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目的探讨脑实质内生殖细胞性肿瘤(GCT)的MRI特点。方法回顾分析6例被长期误诊的脑实质内GCT患者MRI的动态变化,每例患者至少接受2次MRI平扫和1次增强扫描。结果初次MRI检查4例表现为软化灶,2例表现脱髓鞘样改变,无占位性病变;5例患者在确诊时出现占位性病变,分别位于基底节区和胼胝体,囊性变多见,病灶有明显增强;5例患者出现病灶侧大脑脚萎缩,3例出现病灶侧的皮层萎缩,多数在首次MRI检查时已出现。结论脑实质内GCT早期常无占位性病变,容易导致同侧皮层和大脑脚的萎缩,往往到晚期才出现占位性病变,是早期误诊的主要原因。
Objective To investigate the MRI features of intracranial germ cell tumors (GCT). Methods The dynamic changes of MRI in 6 patients with long-term misdiagnosis of intracranial GCT were retrospectively analyzed. At least 2 MRI scans and 1 enhanced scan were performed in each patient. Results The first MRI examination showed softening lesions in 4 cases, demyelination in 2 cases and no space-occupying lesions. In 5 cases, occupying lesions were found at the time of diagnosis, which were located in basal ganglia and corpus callosum, See, the lesions were significantly enhanced; 5 patients showed lesion side cerebral atrophy, cortical atrophy on the side of the lesions in 3 cases, most of the time in the first MRI examination has emerged. Conclusions There is often no space-occupying lesion in brain parenchyma in early stage of GCT, which leads to atrophy of ipsilateral cortical and cerebral peduncle. Occurrence of lesions frequently occurs in late stage of GCT, which is the main reason of early misdiagnosis.