小儿腹膜后神经节源性肿瘤的CT表现  

CT manifestation of retroperitoneal neuroganglionic tumor in children

作　　者：李东辉[1] 徐赛英[1] 祁大文[1] 孙国强[1] 任甄华[1] 宁可[1] 

机构地区：[1]首都医科大学附属北京儿童医院放射科,北京100045

出　　处：《中华放射学杂志》2001年第5期373-377,共5页Chinese Journal of Radiology

摘　　要：目的　描述 2 6例腹膜后神经节源性肿瘤的CT表现 ,以提高对本病的认识。方法　男18例 ,女 8例。经手术、病理 (2 4例 )及临床骨穿 (2例 )证实。成神经细胞瘤、神经节成神经细胞瘤、神经节瘤分别为 14、10、2例 ,平均年龄分别为 1岁 3个月、3岁 6个月、6岁 ,其中神经节瘤 2例分别合并白血病及恶性嗜铬细胞瘤。全部病例于术前作腹部CT平扫 ,其中 14例同时作了增强扫描。术前作B超检查 2 0例。结果　 (1)肿瘤约 2 0cm× 2 5cm× 2 5cm～ 16cm× 10cm× 8cm大小 ,2 6例均位于腹膜后 ,位于一侧 2 2例 ,位于中线上 3例 ,2处多发 1例。 (2 )肿物外形不规则 2 0例 ,类圆形 6例 ;边缘清楚 14例 ,模糊 12例。 (3) 2 5例肿瘤与肾脏对比呈等密度为主的混杂密度 ,1例为均匀低密度 ;2 3例肿瘤有不同形态钙化 ;增强扫描者 12例肿瘤有不均匀增强 ,2例增强不明显。 (4)腹膜后淋巴结肿大19例 ,肝转移 3例 ,肿瘤包埋血管 18例 ,下腔静脉内瘤栓 1例 ,肿瘤侵入椎管 3例。结论　CT平扫可以提示腹膜后神经节源性肿瘤的诊断 ,增强扫描能够进一步明确肿瘤内部及其周围异常。Objective To describe the CT characterization of retroperitoneal neuroganglionic tumor in order to get a better understanding of the disease. Methods Neuroganglionic tumors proved by operation and pathology (24 cases), as well as bone biopsy (2 cases), were studied in 18 males and 8 females. The mean age of neuroblastoma(14 cases), ganglioneuroblastoma(10 cases), and ganglioneuroma (2 cases) was 1 year 3 months, 3 years 6 months, and 6 years, respectively. Two cases of ganglioneuroma were complicated with leukemia and malignant pheochromocytoma. All cases were examined by CT scanning and 14 of them had contrast enhancement scanning preoperatively. 20 cases were also examined by ultrasound. Results The tumor sizes were 2.0 cm×2.5 cm×2.5 cm～16 cm×10 cm×8 cm. The tumors were all located in the retroperitoneal space, 22 cases were unilateral, 3 were situated in mid line prelumboscrally, and 1 was bilaterally located. The tumor were irregular in 20 cases and round shape in 6 cases; the tumor margin showed distinct in 14 cases and indistinct in 12 cases. Twenty five tumors showed mixture density and isointensity comparing with the kidney, 1 case with homogeneouse low density; 12 of 14 cases were enhanced inhomogeneously and 2 did not enhance; 23 of 26 cases showed different shapes of calcification. Retroperitoneal lymph nodes were swelling in 19 cases. Liver metastases were found in 3 cases, vascular encasement in 18 cases, tumor thrombus in inferior vena cava in 1 case,and tumor extending into spinal canal in 3 cases. Conclusion CT scanning can prompt the diagnosis of retroperitoneal neuroganglionic tumor and bolus injection of contrast medium can further increase the understanding of the abnormality within and around the tumor.

关 键 词：腹膜后肿瘤 神经节成神经细胞瘤 CT 诊断 儿童 

分 类 号：R735.4[医药卫生—肿瘤] R730.44[医药卫生—临床医学]