Zusammenfassung
Klinisches/methodisches Problem
Intrakranielle Keimzelltumoren sind in Europa und den USA eine seltene Erkrankung des zentralen Nervensystems (ZNS). Aufgrund ihrer geringen Häufigkeit und fehlenden bildmorphologischen Diagnosekriterien stellen sie eine typische Fallgrube für den Radiologen dar.
Radiologische Standardverfahren
Die Magnetresonanztomographie (MRT) stellt eine sensible Untersuchung zur Erstdiagnostik von Keimzelltumoren dar, hat jedoch alleine deutliche Limitierungen.
Methodische Innovationen
Bisher ist es nicht gelungen, typische bildmorphologische Muster für die unterschiedlichen Keimzelltumoren zu finden. Eine Korrelation mit Klinik und Labor ist für eine Diagnostik unerlässlich.
Leistungsfähigkeit
Durch die Kombination von typischen Lokalisationen mit dem klinischen Erscheinungsbild lässt sich in manchen Fällen die Diagnose auch ohne Histologie stellen.
Bewertung und Empfehlung für die Praxis
Für eine sichere Diagnose benötigt man zusätzlich das Alter, Herkunft, Labor, und klinische Symptomatik.
Abstract
Clinical/methodical issue
Intracranial germ cell tumors are rare central nervous system (CNS) diseases in Europa and America. Because of their low frequency and lack of typical imaging features, they represent a difficult diagnosis for any radiologist.
Standard radiological methods
Magnetic resonance imaging (MRI) is a sensible diagnostic tool for the initial diagnosis of germ cell tumors, although it has limitations.
Methodological innovations
So far, no typical morphologic pattern as a red flag for germ cell tumors has been identified. Correlation with clinical symptoms and laboratory results is mandatory.
Performance
In certain cases, combining the location of the tumor and clinical findings may allow a diagnosis to be made even without histologic confirmation.
Practical recommendations
In addition to imaging, the radiologist needs the age, background, and laboratory findings to be able to make an accurate diagnosis.
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Bachhuber, A. Diagnostik der Keimzelltumoren. Radiologie 63, 598–602 (2023). https://doi.org/10.1007/s00117-023-01172-1
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DOI: https://doi.org/10.1007/s00117-023-01172-1