小儿恶性肝肿瘤的CT与MRI诊断—附45例分析  

CT & MRI Manifestation of Malignant Liver Tumor in Childhood: A Review of 45 Cases

作　　者：邵剑波[1] 胡道予[1] 夏黎明[1] 王承缘[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430040

出　　处：《肿瘤防治研究》2005年第12期777-781,共5页Cancer Research on Prevention and Treatment

摘　　要：目的探讨小儿恶性肝肿瘤的CT与MRI表现特征。方法回顾分析45例经临床、手术及病理证实的恶性肝肿瘤的CT与MRI表现。男24例,女21例,年龄最小37天,最大14岁,平均年龄2.3岁。28例行CT检查,17例行MRI检查,全部病例均行平扫与增强。结果45例中,肝母细胞瘤31例(68.8%)、肝细胞癌4例(8.8%)、肝未分化胚胎性肉瘤3例(6.6%)、肝胆系横纹肌肉瘤3例(6.6%)、肝淋巴瘤2例(4.4%)、肝血管内皮细胞肉瘤2例(4.4%)。瘤体位于肝右叶25例,左叶8例,同时累及2叶以上12例;单发肝肿块37例,多发结节6例,瘤体内钙化17例,假包膜18例,瘤体密度不均,强化不一,其强化程度低于正常肝组织(肝血管内皮细胞肉瘤除外)。结论CT与MRI检查可准确显示恶性肝肿瘤的部位、大小、侵犯范围、影像特点及转移情况,为肿瘤的临床分期、制定治疗方案、估计预后提供重要依据。Objective Our aim was to investigate the imaging manifestation of malignant liver tumor with CT ＆ MRI. Methods Retrospectively review 45 cases of surgically and pathologically confirmed malignant liver tumor. Forty-five patients（24boys, 21girls）, range 37 days to 14 years, mean age 2.3 years. Uncontrast and contrast CT was undertaken in 28 patients and MRI was undertaken in 17 patients. Results All forty-five patients comprised Hepatoblastoma（n = 31）, Hepatocellular Carcinoma （n = 4）, Undifferentiated（embryonal） sarcoma（n = 3）, Hepatobiliary rhabdomyosarcoma, （n = 3）, lymphoma（n = 2） and angiosarcoma（n= 2）. Twenty-five tumors involved the right lobe, 8 tumors involved the left lobe, and 12 both liver lobes. Thirty-seven patients had a solitary hepatic mass, six of them manifested as multiple nodules in one or both liver lobes. Calcified foci were found in 17 cases. Eighteen patients had a pseudocapsule. The tumor mass usually exhibited inhomogeneous density and heterogeneous enhancement and enhances less than normal liver parenchyma（except angiosarcoma ）. Conclusion CT ＆ MRI can precisely delineate the location, size, extent of involvement, imaging characteristics and metastases of liver tumor thus provide information necessary to the clinical staging, therapy planning and prognosis of the tumors.

关 键 词：恶性肝肿瘤 儿童 断层摄影术 X线计算机 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]