足月新生儿肝母细胞瘤CT影像特征分析  

The CT imaging features of hepatoblastoma in term neonates

作　　者：李理 刘文[2] 尹一伟 李春旺[1] 金科[1] Li Li;Liu Wen;Yin Yiwei;Li Chunwang;Jin Ke(Department of Radiology,Hunan Children′s Hospital,Changsha 410007,China;Department of Radiology,the Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]湖南省儿童医院放射科,长沙410007 [2]中南大学湘雅三医院放射科,长沙410013

出　　处：《中华放射学杂志》2020年第2期145-148,共4页Chinese Journal of Radiology

摘　　要：目的探讨足月新生儿肝母细胞瘤(HB)的CT特征。方法回顾性分析2015年1月至2019年1月在湖南省儿童医院经手术病理证实的7例新生儿肝母细胞瘤的临床资料及腹部CT表现特点,重点观察肿块的位置、大小、形态、密度及动态增强特征。结果7例HB患儿CT表现为肝内单发性肿块,其中累及肝Ⅵ段2例、肝Ⅶ段2例、肝Ⅴ+Ⅵ段1例、肝Ⅱ+Ⅲ段1例、肝Ⅳa+Ⅴ+Ⅷ段1例。肿瘤最大径为2.9~10.2 cm,中位数为4.7 cm;类球形4例,不规则分叶状且突向肝外生长3例;边界清晰6例,边界模糊1例;瘤内坏死囊变4例,钙化1例,小片状出血5例;7例肿瘤均呈不均匀强化,动脉期肿瘤中心及边缘出现多发结节状、条片状明显强化;门静脉期及延迟期强化呈进行性区域扩展、充填,呈多发条索状及"岛屿样"强化,且以边缘强化明显,坏死囊变区无强化;1例肿瘤侵犯门静脉及肝门区胆管,并肝内胆管扩张;3例腹腔干水平以下腹主动脉管径变细。病理诊断示肝母细胞瘤上皮胎儿型6例,混合型1例。结论新生儿HB的主要CT表现为可伴有不同程度坏死、出血及钙化的类球形或分叶状肿块,增强扫描呈进行性区域扩展的不均匀明显强化。Objective To investigate the CT features of hepatoblastoma in term neonates.Methods The clinical data and abdominal CT features of 7 children with neonatal hepatoblastoma confirmed by surgical pathology from January 2015 to January 2019 in Hunan Children′s Hospital were retrospectively analyzed,focusing on the position,size,shape,density and dynamic enhancement characteristics of the mass.Results All 7 cases were solitary intrahepatic mass,which affected the liver SⅥin 2 cases,SⅦin 2 cases,SⅤ+Ⅵin 1 case,SⅡ+Ⅲin 1 case,SⅣa+Ⅴ+Ⅷin 1 case.The maximum diameters were 2.9-10.2 cm(median maximum diameter 4.7 cm).Four cases tumors were spherical shape,while 3 cases were irregular lobulation and extended to the outside of live.The boundary was clear in 6 cases and fuzzy in 1 case.Necrosis,calcification,patchy hemorrhage was shown in 4 cases,1 case,5 cases,respectively.All 7 cases tumors showed heterogeneous enhancement,with multiple nodular and lamellar obvious enhancement at the center and edge of the tumor in arterial phase,and gradually filling-in,presented as multiple bands and island-like enhancement,with prominent edge enhanced but no enhancement in the necrotic area in portal venous and delayed phase.The tumor invaded portal vein and bile duct in hilar area in 1 case,with the intra-hepatic bile duct dilation.The caliber of the abdominal aorta below celiac trunk became thinner in 3 cases.6 cases were epithelial fetal type and 1 case was mixed type with pathological confirmed.Conclusion The main CT manifestations of neonatal hepatoblastoma are spherical or lobulated,with varied degrees of necrotic,hemorrhage and calcification,and heterogeneous enhancement with gradually regional expansion.

关 键 词：新生儿 肝母细胞瘤 体层摄影术 X线计算机 甲胎蛋白 

分 类 号：R735.7[医药卫生—肿瘤] R722.1[医药卫生—临床医学]