摘要
目的 分析小儿肾母细胞瘤的 CT表现特点及诊断价值。方法 回顾性 分析我院2014年2月至2017年2月经病理 证实为肾母细胞瘤的小儿患者68例, 所有病例均行CT平行扫加增强扫描,分 析小儿肾母细胞瘤的CT表现特点,并 分析CT征象与手术病理特征关系。结 果 患儿病灶大小为74mm×73mm×98mm146mm×142mm×117mm,分布主要以单侧 多见,多发于上极,病灶多为圆形或类圆 形;平扫显示密度不均匀肿块,在行增强 扫描后病灶部位呈现轻度至中度的不均匀 延迟强化,残存的受推压的肾实质呈“新 月形”或“环形”强化;CT诊断邻近组织 结构侵犯准确率为90.91%,CT诊断有淋巴 结转移准确度为87.50%。结论 肾母细胞 瘤多发于5岁以下儿童,经CT诊断能准确 的显示出肾母细胞瘤的大小、形态、分 布、密度以及侵犯与转移情况,CT表现具 有一定的特征性,对肿瘤分期、临床治疗 方案的制定以及预后判断有着重要意义。
Objective To analyze the CT features and diagnostic value of nephroblastoma in children. Methods A total of 68 children with pathologically confirmed nephroblastoma who were admitted to our hospital between February 2014 and February 2016 were retrospectively analyzed. All cases underwent CT plain scan and enhanced scan. The CT features of nephroblastoma in children were analyzed, and the relationship between the CT features and surgical and pathological characteristics was analyzed. Results The average size of lesions in children was 4mm×73mm×98mm-146mm×142mm×117mm. The lesions were mainly distributed on one side and mostly occur in the upper pole. The lesions are mostly round or circular. Plain scan showed masses with uneven density. After the enhanced scan, the lesions showed mild to moderate uneven and delayed enhancement, and the residual pressed renal parenchyma showed crescent or annular enhancement. The accuracy of CT in the diagnosis of adjacent tissue invasion was 90.91%, and in the diagnosis of lymph node metastasis was 87.50%. Conclusion Nephroblastoma is more common in children under 5 years old. CT can accurately show the tumor size, shape, distribution, density, invasion and metastasis of nephroblastoma. The findings of CT are characteristic, which is of great importance to tumor staging,development of treatment plan and prediction of prognosis.
【关键词】小儿;肾母细胞瘤;体层摄影 技术,X线计算机;诊断
【中图分类号】R322.6+1
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.09.032
前言
肾母细胞瘤是小儿泌尿系统中最为常见的恶性肿瘤之一,是一种 胚胎发育性肿瘤,是肾胚基细胞在出生后不久因不能正常分化和继续 增殖所导致的,5岁以下儿童发病率最高,患儿临床症状表现为腹部 肿块、疼痛、血尿、发热、消化系统症状等[1-2]。小儿肾母细胞瘤生 长迅速,恶性程度高,易发生转移,严重影响患者预后,威胁其生命 安全,因此对该疾病进行早期诊断,尽早进行手术切除治疗具有重要 的临床意义[3]。随着影像学技术的不断进步,临床上对小儿肾母细胞 瘤的诊断准确率也在不断提高,术前对肾脏肿瘤病理分型进行准确判 断,有利于实施相应的治疗手段,CT对肾母细胞瘤筛查具有其特征 性,因此在手术治疗前进行CT诊断非常有必要[4-5]。本次研究我们特选 取我院经病理证实为肾母细胞瘤的小儿患者68例,对其进行CT平扫及 增强扫描,期望通过分析CT表现特点提高临床对肾母细胞瘤的认识, 提高影像诊断准确率。现将结果报告如下。
中国CT和MRI杂志
第15卷, 第 9 期
2017年09月
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