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儿童腹部囊性肿块 的CT特点及诊断价 值

作者:王耀光1 湖湘萍2 王 昀1 汪广兵1 赵腾府1

所属单位:1.河南省濮阳市人民医院小儿外科 (河南 濮阳 457000) 2.河南省濮阳市人民医院儿二科 (河南 濮阳 457000)

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摘要

目的 研究儿童腹部囊性肿块的 CT特点和临床诊断价值。方法 回顾性分 析我院81例腹部囊性肿块患儿的临床资 料,分析肿块CT特点,并与手术或病理结 果进行比较。结果 81例患儿腹部囊性肿 块中,真性囊肿24例(29.63%),假性囊肿 12例(14.81%);囊性畸形19例(23.46%), 均呈边缘清晰囊性肿块;囊性肿瘤21例 (25.93%),呈囊性肿块、微腔肿瘤或大囊 肿瘤,部分可见钙化或强化;腔道积水或 积脓5例(6.17%),单侧肾盂积水可见中央 密度低、外围呈半月形,增强扫描外围肾 实质可见强化;阑尾脓肿可见盲肠周围积 聚有液体,壁厚且不规则;CT诊断正确的 有77例,符合率为95.06%。结论 CT可全 面、直观显示儿童腹部囊性肿块特征,为 病变肿块的临床治疗提供重要依据。

Objective To study CT features and clinical values of children with abdominal cystic masses. Methods The clinical data of 81 cases of children with abdominal cystic masses in our hospital were retrospectively analyzed. The CT features of masses were analyzed and compared with surgical or pathological findings. Results Among the 81 cases of children with abdominal cystic masses, there were 24 cases (29.63%) of true cysts, 12 cases (14.81%) of pseudocysts, 19 cases (23.46%) of cystic deformity with clear cystic masses, 21 cases (25.93%) of cystoma with cystic masses, microcavity tumor or large capsule tumor and partial calcification and enhancement, and 5 cases (6.17%) of cavity effusion or empyema. And unilateral hydronephrosis was seen central low density and peripheral half-moon shape, and enhancement was visible in the peripheral renal parenchyma by enhanced scan in the 5 cases. And the appendiceal abscess was seen accumulation of liquid around the cecum and thick and irregular wall. 77 cases were correctly diagnosed by CT with the coincidence rate of 95.06%. Conclusion CT can be a comprehensive and intuitive display of abdominal cystic mass characteristics of children, and can provide an important basis for the clinical treatment of diseased masses.

【关键词】腹部囊性肿块;儿童;CT诊断

【中图分类号】R725.7;R445.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.04.038

前言

人体肝、肾、脾等实质性脏器、胃肠道、生殖系统等空腔脏器和 肠系膜等组织均位于腹腔,儿童腹部囊性肿块种类繁多,肿块小时 未发现,大多在肿块直径超过3cm,大到腹部可触及肿块时才入院就 诊[1]。肿块压迫周围组织和器官,并使它们发生移位,影像学检查时 往往显示的是非正常的解剖结构,给囊性肿块的诊断带来考验[2]。本 研究回顾性分析我院2014年3月~2017年3月期间收治的81例腹部囊性 肿块患儿的临床资料,对其CT特点进行分析,以期为儿童腹部囊性肿 块临床诊断提供更多的线索。