原发性纵隔卵黄囊瘤的CT表现

目的:提高对原发性纵隔卵黄囊瘤的CT诊断准确率。方法:回顾性分析13例原发性纵隔卵黄囊瘤的临床表现及CT特征。结果:13例患者中均为年轻男性，年龄18～33岁，平均年龄为25岁，肿瘤均位于前纵隔，其中右前纵隔7例，左前纵隔2例，前中纵隔4例；13例患者中7例行血清甲胎蛋白（AFP）定量检测，均高于正常值；12例直径大于8cm，增强后9例呈不均匀强化，4例均匀强化；12例与大血管关系密切，其中6例明显包绕邻近大血管；6例可见胸腔积液，3例可见心包积液；3例纵隔有肿大淋巴结。结论:原发性纵隔卵黄囊瘤好发于年轻男性，常位于前纵隔，病灶体积较大，内可见多发囊变坏死区，CT可以清楚显示病灶与邻近血管的关系，结合AFP检测有助于提高其诊断准确率。 

CT Findings of Primary Mediastinal Yolk Sac Tumor

Objective:To improve the CT diagnostic accuracy of primary mediastinal yolk sac tumor. Methods:The clinical manifestations and CT features of 13 cases with primary mediastinal yolk sac tumor were analyzed retrospectively. Results:All the 13 patients were young males, aged 18-33 years old, with an average age of 25 years old. All the tumors were located in the anterior mediastinum, including 7 cases in the right anterior mediastinum, 2 cases in the left anterior mediastinum, and 4 cases in the anterior middle mediastinum. Seven of the 13 patients were tested for serum alpha-fetoprotein (AFP), all of which were higher than normal. In 12 cases, the diameter was greater than 8cm, 9 cases showed uneven enhancement after enhancement, and 4 cases showed uniform enhancement. Twelve cases were closely related to the great vessels, among which 6 cases obviously surrounded the adjacent great vessels. Pleural effusion was found in 6 cases, pericardial effusion in 3 cases. There were enlarged mediastinal lymph nodes in 3 cases. Conclusion:Primary mediastinal yolk sac tumor is more likely to occur in young men, often located in the anterior mediastinum, with a large lesion volume and multiple cystic necrotic areas. CT can clearly show the relationship between the lesion and adjacent blood vessels, and combined with AFP detection can help improve its diagnostic accuracy.