儿童肾母细胞瘤的CT诊断价值  

CT diagnosis of nephroblastoma in children

作　　者：张永平[1] 虞崚崴[1] 范国平[1] 任刚[1] 程普选[1] 薛建平[1] 

机构地区：[1]上海第二医科大学附属新华医院放射科,200092

出　　处：《上海医学影像》2005年第1期63-64,共2页Shanghai Medical Imaging

摘　　要：目的探讨CT对儿童肾母细胞瘤诊断与分期的价值。方法回顾性分析54例经手术、病理证实为肾母细胞瘤的CT表现。全部病例均行平扫与增强检查。结果原发肿瘤多起源于肾脏一侧,上极多于下极,肿瘤大小与预后无关;本组91%组织学为“有利”型,不均匀强化的实质性肿瘤伴坏死与出血;被肿瘤侵犯、压迫后残存肾实质呈“新月型”强化为典型CT表现。本组术前定性诊断准确率为98%。腹膜后、膈脚后淋巴结转移最多见,其次为胸部转移。“不利”型肿瘤有远隔转移。结论CT检查可准确显示原发肿瘤侵犯的范围,及时发现转移瘤,为肿瘤分期、制订治疗方案,估计预后提供重要依据。Purpose To evaluate the diagnostic value and staging of nephroblastoma in children by computed tomography. Methods CT manifestations in 54 cases of nephroblastoma proved by surgery and pathology were studied retrospectively. All the patients received plain scans and enhancement with intravenous contrast medium. Results Primary tumor originated from one the kidney, upper pole more than lower one. The sizes of tumors were not correlated with outlook. 91 percents of patients were classified as having favorable histology. Mixed contrast-enhanced reparenchyma with hemorrhage and the remaining renal parenchyma exhibited a 'new-moon shape' enhancement type which was caused by pressure effect and invasive of the tumor. Preoperative diagnostic accuracy was 98%. Early metastasis was seen in the lymph node retroperitoneal and posterior to diaphragtic crus, and than in the chest. Metastasis of the unfavorable histology of nephroblastoma tended to from the diaphragm. Conclusion CT is recognized as a useful technique for the detection of area, invasion, metastasis, and staging, and provides important evidence for the treatment and prognosis.

关 键 词：肾母细胞瘤 原发肿瘤 CT诊断 CT表现 儿童 预后 转移 腹膜后 肿瘤侵犯 膈脚 

分 类 号：R737.11[医药卫生—肿瘤] R739[医药卫生—临床医学]