多排螺旋CT联合超声对儿童双侧肾母细胞瘤的诊断  

Multi-slice Spiral CT Combined with Ultrasound in the Diagnosis of Bilateral Nephroblastoma in Children

作　　者：薛潋滟 施美华 纪慧 董素贞 XUE Lian-yan;SHI Mei-hua;JI Hui;DONG Su-zhen

机构地区：[1]上海交通大学医学院附属上海儿童医学中心放射科

出　　处：《中国医学计算机成像杂志》2019年第3期303-306,共4页Chinese Computed Medical Imaging

摘　　要：目的:探讨儿童双侧肾母细胞瘤的影像学特征,以及多排螺旋CT联合超声对其术前诊断价值。方法:回瞻性分析我院17例患儿儿童双侧肾母细胞瘤(BWT)的超声和CT影像学图像,其中12例术前行腹部超声和增强CT检査;5例术前仅行腹部CT扫描。全部经手术病理证实。结果:17例发病年龄为4个月~ 2岁,中位年龄11-8月。12例超声表现为肿瘤均表现为中低不均匀混合回声占位,内部出血、坏死区域呈无回声区,其中2例瘤体内可见大小及数量不等的囊腔,3例瘤体内可见强回声钙化;CT表现为其中16例体积较大肿瘤呈不均匀混和密度,其中1例左侧体积偏小肿瘤表现为较均匀实性低密度,其中4例较大侧肿瘤内见高密度钙化。CT增强后实质部分不均匀强化,坏死及囊变区未见强化,包膜和内部分间隔可见强化,残存肾实质呈新月形强化。结论:超声和CT检查术前均能准确显示双侧肾母细胞瘤的瘤体大小、形态、密度、侵犯的范围及转移情况,但CT对于较大肿瘤边界及残余情况显示稍佳,两者在诊断中能起到互补作用,两者结合能更准确术前评估双侧肾母细胞瘤。Purpose: To evaluate the preoperative diagnostic value and imging features of multi-slice spiral CT combined with ultrasound for bilateral nephroblastoma in children. Methods: Seventeen cases of bilateral nephroblastoma (BWT) in our hospital were analyzed retrospectively. Of them, 12 cases had both abdominal ultrasound and enhanced CT, and 5 cases had abdominal CT scans only. All 17 cases were confirmed by surgical pathology results. Result: The age of 17 children ranged from 17 months to 2 years (mean 1 year old). In 12 cases, ultrasound revealed moderate to low heterogeneous echo. Among the 12 cases, 2 cases showed cysts with various size and 3 cases showed strong echo with calcification. In 16 of 17 cases, CT revealed larger tumors with mixed density, and 1 of 17 showed a small tumor in the left side with relatively homogeneous solid low density. Four of the 17 cases showed calcification with high intensity. On CT with contrast enhancement, the solid part of the tumor was heterogeneously enhanced. The necrosis and cystic area were not enhanced. The capsule and septa of the tumor were enhanced, and the remaining renal parenchyma was enhanced with crescent shape. Conclusion: Ultrasound and CT can accurately display the size,shape, density, extent of invasion and metastasis of bilateral nephroblastoma before surgery, but CT is better in evaluating borders and residual parenchyma. Ultrasound and CT could complement each other in the diagnosis, the combination of these two methods could more accurately assess the bilateral nephroblastoma before surgery.

关 键 词：儿童 双侧肾母细胞瘤 超声 X线让算机 体层摄影术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]