小儿胰母细胞瘤的影像学诊断(附九例报告及文献复习)  

Imaging diagnosis of pancreatoblastoma: a report of 9 cases and review of the literature

作　　者：罗平风[1] 徐赛英[1] 贾立群[2] 祝秀丹[3] 何乐健[4] 王小平[5] 庄严阵[6] 

机构地区：[1]首都医科大学附属北京儿童医院放射科,100045 [2]首都医科大学附属北京儿童医院B超室,100045 [3]首都医科大学附属北京儿童医院外科,100045 [4]首都医科大学附属北京儿童医院病理科,100045 [5]厦门市第一医院CT室 [6]厦门市第一医院病理科

出　　处：《中华放射学杂志》1999年第9期633-636,共4页Chinese Journal of Radiology

摘　　要：目的　旨在提高对小儿胰母细胞瘤影像学方面的认识和诊断水平。方法　 9例经手术病理证实的小儿胰母细胞瘤术前均经B超检查 ,另外行CT平扫加增强 3例 ,其中 2例并行胃肠造影(GI)检查 ;CT平扫加GI 1例 ,单行静脉肾盂造影 (IVP) 3例 ,GI 1例。结果　B超显示 4例失去正常胰腺回声 ,6例可见瘤内钙化声影。 4例CT扫描 ,肿瘤分别位于胰头、头体、体尾及胰尾部 ,显示为巨大块状混杂低或等密度影。 2例瘤内有钙化灶 ,增强后肿瘤周边部呈小叶样网状强化 ,瘤实质呈不均等强化 ,中心坏死区无强化。肿瘤对化学药物治疗 (简称化疗 )敏感。 9例中 5例经术后化疗存活至今 ,最长 8年 ,3例失随访 ,1例肿瘤转移死亡。结论　CT和B超是当前影像学诊断本病的首选检查方法。胰腺区发现瘤体较大 ,含包膜 ,瘤周边部分成小叶样网状强化及钙化灶时应考虑本病。Objective Analyzing the imaging feature of pancreatoblastima(PB) in children in order to improve the diagnostic level Methods 9 cases with PB comfirmed by operation and pathology were examined by US before operations 3 cases had pre and post enchanced CT scan CT scan was performed in one and 4 cases had GI study Results US showed loss of normal pancreatic echo in 4 cases Echo shadow due to calcified foci were noted in 6 cases Pre and/or post enchanced CT scan of 4 cases demonstrated the mass with inhomogeneous hypo or iso density in pancreatic head, body and tail respectively Unenhanced CT scan demonstrated calcified foci in 2 cases After contrast, the tumor appeared well circumscribed and demonstrated peripheral lobuler network like enhancement and low density of central necrosis The tumor showed good response to chemotherapy Of the 9 cases, 5 are alive including one patient still living 8 years after treatment, one died of widespread metastasis,2 loss of follow up Conclusions CT and US are the initial modalities of choice to diagnose PB Calcified foci, a large tumor with capsule and peripheral lobular network like enhancement are findings suggestive of PB

关 键 词：胰腺肿瘤 胰母细胞瘤 CT 诊断 儿童 

分 类 号：R735.904[医药卫生—肿瘤]