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。
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.
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
Key words
Endodermal sinus tumor /
Sacrococcygeal region /
Child /
Tomography, X-ray computed /
Magnetic resonance imaging
中图分类号：
Ｒ738.1
R445.2
Ｒ814.42
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