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目的总结回顾以尿崩症为首要表现之颅内生殖细胞瘤(germ cell tumors,GCTs)的MRI表现特点,以提高对本病的MRI诊断。方法分析归纳本院病理证实的以尿崩症为主要临床症状的颅内生殖细胞瘤3例,术前均行MRI平扫及增强检查。结果 3例病例均有突然发生的不同程度尿崩症;3例病例早期MRI均表现为垂体后叶短T1WI信号消失,2例表现为垂体后叶短T1WI信号消失并垂体柄增粗,1例垂体柄增粗呈结节样;随病情及时间推进,3例病例鞍上区及(或)松果体区出现不规则结节状、块状病变,呈等T1等T2信号;增强后病变呈明显不均匀强化。结论首发症状为尿崩症的病人,应及时行MRI检查;如出现垂体后叶短T1WI信号消失并垂体柄增粗,要考虑到GCTs病,本病影像表现多数随病情及时间推移,颅内出现鞍上区及松果体区病变,是其特征性表现。
Objective To summarize the MRI features of germ cell tumors (GCTs), which is the most important manifestation of diabetes insipidus, in order to improve the MRI diagnosis of this disease. Methods Three cases of intracranial germinoma with diabetes insipidus as the main clinical manifestations confirmed by pathology in our hospital were summarized and analyzed by MRI and enhanced MRI before operation. Results All 3 cases had sudden onset of diabetes insipidus. Early MRI showed the short T1WI signal disappeared in the posterior pituitary gland, the shortening of the T1WI signal in the posterior pituitary gland and the thickening of the pituitary stalk in 2 cases, Pituitary stalk thickening nodules; with the disease and time to advance, 3 cases of supraspinatus and (or) pineal region irregular nodules, massive lesions showed T1 and other T1 signal; enhanced lesion Obviously uneven enhancement. Conclusion The first symptom of patients with diabetes insipidus should be timely MRI examination; such as the emergence of short posterior pituitary T1WI signal disappears and pituitary stalk thickening, taking into account the GCTs disease, most of the performance of the disease with the disease and the time course of imaging, intracranial Appear on the area and pineal pineal lesions, is its characteristic performance.