儿童骶尾部卵黄囊瘤的影像学表现

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：分析儿童骶尾部卵黄囊瘤的CT或MRI影像学表现，并与病理对照，旨在提高对本病的认识。方法：回顾性研究经手术病理证实的21例骶尾部卵黄囊瘤的CT或MRI表现，并分析其病理基础。结果：21例骶尾部卵黄囊瘤，均表现为单发不规则软组织肿块，多数边缘清楚，密度/信号不均匀，均呈明显不均匀强化，提示含不同程度的囊变坏死，其中7例可见条状血管样强化，6例见肿瘤内出血，21例均有尾骨的包绕侵犯，7例伴骶管侵犯转移，9例有肺部多发转移，2例骨转移，12例DWI序列上均表现为高信号，ADC值范围为（0.63~1.32）×10-3 mm2/s；21例卵黄囊瘤患者AFP值均有不同程度的升高。结论：骶尾部是性腺外卵黄囊瘤的主要发生部位，好发于婴幼儿，多数小于3岁，易发生出血、坏死和小的囊变，CT和MRI结合术前AFP检查可提高术前诊断的准确性，还可明确肿瘤累及的范围，对临床选择治疗方案、预后评估有重要意义。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	陆征海
	丁茗
	蔡静
	崔雪娥
	朱景雨
	朱锦勇
	汪登斌

关键词 ：内胚层窦瘤, 骶尾部, 儿童, 体层摄影术, X线计算机, 磁共振成像

Abstract：Objective: To improve the accuracy of preoperative diagnosis of sacrococcygeal yolk sac tumor in children by correlating the CT or MR imaging features with histopathology. Methods: CT or MR imaging findings of sacrococcygeal yolk sac tumor in 21 cases confirmed by surgery and pathology were retrospectively reviewed. Results: All the 21 tumors appeared as soft-tissue masses and most of them were well-defined. The tumors were heterogeneous in terms of density or signal intensity and were always associated with different degree of necrotic and cystic change area. Among them, 7 cases showed blood vessels enhancement on contrast-enhanced CT or MRI, 6 cases showed small patch intratumor hemorrhage. All the 21 cases surrounded and invaded the coccyx, with 7 cases extending into the canalis vertebralis. What is more, multiple lung metastases were found in 9 cases and bone metastases were shown in 2 cases. All the 12 cases demonstrated hetergeneous hyperintensity on DWI, with the ADC value was between (0.63~1.32)×10-3 mm2/s. Serum AFP level of all the 21 yolk sac tumors increased. Conclusion: Sacrococcygeal yolk sac tumors always occurs in infants and young children, especially less than 3 years old, and are prone to hemorrhage, necrosis and cystic change. CT or MRI examination combined with serum AFP examination can improve the accuracy of preoperative diagnosis, and also can determine the range of tumor involvement, which is important for selection for clinical treatment and prognosis assessment.

Key words： Endodermal sinus tumor Sacrococcygeal region Child Tomography, X-ray computed Magnetic resonance imaging

收稿日期: 2015-08-11

PACS:	Ｒ738.1
	R445.2
	Ｒ814.42

通讯作者: 汪登斌

引用本文:

陆征海，丁茗，蔡静，崔雪娥，朱景雨，朱锦勇，汪登斌. 儿童骶尾部卵黄囊瘤的影像学表现[J]. 中国临床医学影像杂志, 2016, 27(3): 198-201.
LU Zheng-hai, DING Ming, CAI Jing, CUI Xue-e, ZHU Jing-yu, ZHU Jin-yong, WANG Deng-bin . Imaging findings of sacrococcygeal yolk sac tumor in children. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(3): 198-201.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2016/V27/I3/198

[1]Kocaoglu M, Frush DP. Pediatric presacral masses[J]. Radiographics, 2006, 26(3): 833-857.
[2]Calaminus G, Schneider DT, Bokkerink JP, et al. Prognostic value of tumor size, metastases, extension into bone, and increased tumor marker in children with malignant sacrococcygeal germ cell tumors: a prospective evaluation of 71 patients treated in the German cooperative protocols Maligne Keimzell tumor en(MAKEI) 83/86 and MAKEI 89[J]. J Clin Oncol, 2003, 21(5): 781-786.
[3]Marina N, London WB, Frazier AL, et al. Prognostic factors in children with extragonadal malignant germ cell tumors: a pediatric intergroup study[J]. J Clin Oncol, 2006, 24(16): 2544-2548.
[4]Baranzelli MC, Kramar A, Bouffet E, et al. Prognostic factors in children with localized malignant nonseminomatous germ cell tumors[J]. J Clin Oncol, 1999, 17(4): 1212.
[5]Steinbacher DM, Upton J, Rahbar R, et al. Yolk sac tumor of the mandible[J]. J Oral Maxillofac Surg, 2008, 66(1): 151-153.
[6]Altman RP, Randolph JG, Lilly JR. Sacrococcygeal teratoma: American Academy of Pediatrics Surgical Section Survey-1973[J]. J Pediatr Surg, 1974, 9(3): 389-398.
[7]Rescorla FJ. Pediatric germ cell tumors[J]. Semin Pediatr Surg, 2012, 21(1): 51-60.
[8]Horton Z, Schlatter M, Schultz S. Pediatric germ cell tumors[J]. Surg Oncol, 2007, 16(3): 205-213.
[9]Ueno T, Tanaka YO, Nagata M, et al. Spectrum of germ cell tumors: from head to toe[J]. Radiographics, 2004, 24(2): 387-404.
[10]Yoshida M, Matsuoka K, Nakazawa A, et al. Sacrococcygeal yolk sac tumor developing after teratoma: a clinicopathological study of pediatric sacrococcygeal germ cell tumors and a proposal of the pathogenesis of sacrococcygeal yolk sac tumors[J]. J Pediatr Surg, 2013, 48(4): 776-781.
[11]Sayed HA, Ali AM, Hamza HM, et al. Sacrococcygeal tumors: clinical characteristics and outcome of pediatric patients treated at South Egypt Cancer Institute. A retrospective analysis[J]. J Pediatr Surg, 2013, 48(7): 1604-1608.
[12]Lo Curto M, D’Angelo P, Cecchetto G, et al. Mature and immature teratomas: results of the first pediatric Italian study[J]. Pediatr Surg Int, 2007, 23(4): 315-322.
[13]De Backer A, Madern GC, Hakvoort-Cammel FG, et al. Study of the factors associated with recurrence in children with sacrococcygeal teratoma[J]. J Pediatr Surg, 2006, 41(1): 173-181.
[14]International Germ Cell Cancer Collaborative Group. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers[J]. J Clin Oncol, 1997, 15(2): 594-603.
[15]许恪淳，管雯斌，许艳春，等. 儿童卵黄囊瘤病理学特征及鉴别诊断[J]. 上海交通大学学报：医学版，2013，33（2）：200-203.
[16]翟健坤，粱欢庆．盆部内胚窦瘤临床表现及CT特征[J]．实用医学影像杂志，2009，10（2）：116-118.
[17]李文华，张永平，俞炬明. 小儿骶尾部生殖细胞源性肿瘤的CT诊断和MRI诊断[J]. 中国医学计算机成像杂志，2001，7（6）：406-408．
[18]范森，彭谦，王晓燕．小儿骶前肿瘤的CT诊断和MRI诊断[J]. 癌症，2009，28（4）：420-424．
[19]Choi HJ, Moon MH, Kim SH, et al. Yolk sac tumor of the ovary: CT findings[J]. Abdom Imaging, 2008, 33(6): 736-739.
[20]Yamaoko T, Togashi K, Koyamo T, et al. Yolk sac tumor of the ovary: radiologic-pathologic correlation in four cases[J]． J Comput Assist Tomogr, 2000, 24(4): 605-609．
[21]Li Y, Zheng Y, Lin J, et al. Radiological-pathological correlation of yolk sac tumor in 20 patients[J]. Acta Radiol, 2016, 57(1): 98-106.
[22]Amzallag-Bellenger E, Soyer P, Barbe C, et al. Diffusion-weighted imaging for the detection of mesenteric small bowel tumours with magnetic resonance enterography[J]. Eur Radiol, 2014, 24(11): 2916-2926.