婴幼儿肾脏肿瘤的CT诊断价值  

Diagnosis of Renal Tumor in Infants by CT

作　　者：鄂天娇 李玉华[1] 郑慧[1] 曹雯君[1] 夏正荣[1] 

机构地区：[1]上海交通大学医学院附属新华医院放射科

出　　处：《中国医学计算机成像杂志》2016年第2期157-161,共5页Chinese Computed Medical Imaging

摘　　要：目的：探讨婴幼儿肾脏肿瘤的CT诊断价值。方法：回顾性分析经病理证实的64例婴幼儿肾脏肿瘤的临床及CT资料,总结其肿瘤的类型以及CT表现。结果：肾母细胞瘤46例（46/64,71.9%）,年龄5-36个月,平均17.8个月,CT主要表现为肾内混杂密度肿块伴较明显囊变坏死,可伴钙化（14/46,30.4%）,5例伴下腔静脉或肾静脉内癌栓,2例同时发现肺内转移灶;3例Botroyid肾母细胞瘤表现为集合系统内肿瘤;3例部分囊状分化的肾母细胞瘤表现为多个微囊性肿瘤。中胚层肾瘤6例,均1岁以下,CT表现类似肾母细胞瘤。横纹肌样瘤2例,CT也表现为混杂密度肿块;1例1个月,见包膜下积液表现,伴多发转移灶;1例24个月,下腔静脉内见癌栓。透明细胞肉瘤5例,均2岁以下,平均16个月,CT表现与肾母细胞瘤相似,坏死更显著,1例同时发现两肺、肋骨等多发转移灶。婴儿骨化性肾肿瘤2例,年龄分别为4个月和6个月,临床表现为血尿,肿瘤均位于肾盏,体积较小,肿块以斑片状钙化为主。肾透明细胞癌1例,年龄36个月。肾成熟性畸胎瘤1例,表现为多房囊性病变伴斑片样钙化及少许脂肪密度。多囊性肾瘤1例。结论：婴幼儿肾脏肿瘤病理类型复杂,肾母细胞瘤占多数（71.9%）,但是1岁以内肾母细胞瘤的发生率下降（17/29,58.6%）,中胚叶肾瘤、婴儿骨化性肾肿瘤多发生在一岁内。婴幼儿肾脏肿瘤的诊断需将CT表现与临床资料紧密结合起来,这样大部分肾脏肿瘤能在术前做出正确诊断,从而为临床治疗方案制定提供重要信息。Purpose： To investigate the value of CT in diagnosis of renal tumors of infants. Methods： The manifestations and CT imaging features of 64 cases renal tumors proved by surgery and pathology were studied retrospectively. Results： Of all the cases, 46（46/ 64, 71.9%） were Wilm＇s tumor at an average age of 17.8 months. These tumors represented as heterogeneous soft-tissue-attenuation masses with the appearance of necrosis and calcification（14/46, 30.4%）. Intravascular extension could be found in 5 cases and 2 cases with metastatic foci in the lung; Three cases were Botryoid Wilm＇s tumors, they were originated from renal collecting system; Three cases were cystic partially differentiated nephroblastomas, they appeared as masses consisting of multiple small cysts. Six cases were mesoblastic nephromas. All the cases were under 1 year old which appeared similar to the Wilm＇s tumor; Two cases were rhabdoid tumors, one was one month old with subcapsular hydrops and multiple metastatic lesions, the other was 2 years old with intravascular extension; Five cases were clear cell sarcomas. All the cases were under 2 years old, they appeared as heterogeneous masses with serious necrosis, 1 case was with metastatic lesions in the lung, ribs, chest wall; Two cases were ossifying renal tumor of infancy, one was 4 months old, the other was 6 months old. The clinical manifestation was hematuria. The tumors were small and located in calyx with plaque-likecalcification; There was 1 case of renal clear cell carcinoma and 1 case of multi-locular cystic renal tumor. 1 case was renal mature teratoma with calcification and spot-like fat tissues. Conclusions： The pathological types of renal tumors in infants are various. The nephroblastoma take up the major parts（71.9%）, while the incidence rate descends to 58.6% in the renal tumors within 1 year old. According to the clinical manifestations and CT imaging features, a lot of renal tumors in infants can be diagnosed correctly before operation, thus offer great help t

关 键 词：婴幼儿 肾肿瘤 体层摄影术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤] R730.44[医药卫生—临床医学]