超声和CT在儿童神经母细胞瘤诊断、临床分期和治疗方案制定中的价值分析  

Analysis of the value of ultrasound and CT in the diagnosis,clinical staging and treatment planning of neuroblastoma in children

作　　者：王艳晓[1] 王婕妤[2] 刘颖[3] 马灵芝[1] Wang Yanxiao;Wang Jieyu;Liu Ying;Ma Lingzhi(Department of Ultrasound,4th Hospital of China Medical Univercity,Liaoning Shenyang 110032,China;Department of Radiology,4th Hospital of China Medical Univercity,Liaoning Shenyang 110032,China;Department of Pediatrics,4th Hospital of China Medical Univercity,Liaoning Shenyang 110032,China)

机构地区：[1]中国医科大学附属第四医院超声科,辽宁沈阳110032 [2]中国医科大学附属第四医院放射科,辽宁沈阳110032 [3]中国医科大学附属第四医院儿科,辽宁沈阳110032

出　　处：《现代肿瘤医学》2020年第13期2291-2294,共4页Journal of Modern Oncology

基　　金：沈阳市科技计划项目(编号:F13-221-9-43)。

摘　　要：目的:对比分析超声和CT对儿童神经母细胞瘤的诊断价值以及二者在该病临床分期和治疗方案制定中的价值。方法:筛选经病理证实的儿童神经母细胞瘤34例(其中术后证实瘤内钙化者26例),分析其临床及影像资料。结果:本研究的34例患者中,有29例超声显示为大小不等、回声不均匀的实性肿块,其中20例肿块表现为跨中线生长,18例包绕腹部大血管,18例后腹膜淋巴结肿大,且有9例、8例和2例分别为肾脏、肝脏、脾脏受累患者。本研究中有28例患者在术前通过超声进行了确诊,其符合率高达82.4%,特征性瘤内钙化的检出率达88.5%(23/26);CT示大小不等、密度不均匀的肿块34例,增强可见明显强化,包绕大血管者18例,跨中线生长者20例,侵犯椎管腔者8例,后腹膜淋巴结肿大者15例,肾脏、肝脏、脾脏受累者分别为9例、6例、1例,头颅转移者7例,30例术前做出正确诊断,术前CT诊断符合率为88.2%,瘤内钙化的检出率高达96.2%(25/26)。结论:儿童神经母细胞瘤有其典型的影像学表现,超声和CT对该病的诊断符合率都很高,且各具优势,二者联合应用对儿童神经母细胞瘤的诊断、临床分期和指导治疗有重要价值。Objective:To compare and analyze the diagnostic value of ultrasound and CT in children neuroblastoma and their guiding value in clinical staging and treatment program formulation.Methods:34 cases of pediatric neuroblastoma confirmed by pathology(including 26 cases of intratumor calcification confirmed after surgery)were screened.Their clinical and imaging data were analysed.Results:Among the 34 cases,ultrasound showed 29 cases of solid masses with unequal size and uneven echo,including 18 cases wrapped around large abdominal vessels,20 cases of trans-midline growth,18 cases of retroperitoneal lymphadenopathy,9,8 and 2 cases were involved in kidney,liver and spleen,respectively.In this study,28 patients were diagnosed by ultrasound before surgery,and the coincidence rate was 82.4%.The detection rate of characteristic intratumoral calcification was 88.5%(23/26).CT showed 34 cases of lumps with unequal size and density,and obvious enhancement could be seen by contrast enhancement,including 18 cases wrapped around large abdominal vessels,20 cases of trans-midline growth,8 cases invaded vertebral canal cavity,15 cases of retroperitoneal lymphadenopathy,9 cases of kidney involvement,6 cases of liver involvement,1 case of spleen involvement and and 7 cases of head metastasis.Correct preoperative diagnosis was made in 30 cases,and coincidence rate of CT diagnosis was 88.2%.The detection rate of intratumoral calcification was 96.2%(25/26).Conclusion:Pediatric neuroblastoma has its typical imaging manifestations.Both ultrasound and CT have high diagnostic coincidence rates,and each has irreplaceable advantages.The combined application of the two has important value for the diagnosis,clinical staging and treatment guidance of pediatric neuroblastoma.

关 键 词：神经母细胞瘤 儿童 超声 体层摄影术 

分 类 号：R730.264[医药卫生—肿瘤]